Provider Demographics
NPI:1417312836
Name:MAURER, TABITHA ANN (ATC, PES)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:ANN
Last Name:MAURER
Suffix:
Gender:F
Credentials:ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 HATFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2921
Mailing Address - Country:US
Mailing Address - Phone:610-392-6912
Mailing Address - Fax:
Practice Address - Street 1:4710 HATFIELD ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-2921
Practice Address - Country:US
Practice Address - Phone:610-392-6912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer