Provider Demographics
NPI:1447385547
Name:TIER OCCUPATIONAL THERAPY SERVICES, PC
Entity Type:Organization
Organization Name:TIER OCCUPATIONAL THERAPY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRINK
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:607-761-3487
Mailing Address - Street 1:616 MOUNTAIN VALLEY RD. TIER OT SERVICES
Mailing Address - Street 2:
Mailing Address - City:HALLSTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:18822-9169
Mailing Address - Country:US
Mailing Address - Phone:607-761-3487
Mailing Address - Fax:570-879-8824
Practice Address - Street 1:616 MOUNTAIN VALLEY RD. TIER OT SERVICES
Practice Address - Street 2:
Practice Address - City:HALLSTEAD
Practice Address - State:PA
Practice Address - Zip Code:18822-9169
Practice Address - Country:US
Practice Address - Phone:607-761-3487
Practice Address - Fax:570-879-8824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012795000001Medicaid