Provider Demographics
NPI:1518091933
Name:MCCANN, DIANE PATRICIA (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:PATRICIA
Last Name:MCCANN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4456
Mailing Address - Country:US
Mailing Address - Phone:412-366-1871
Mailing Address - Fax:412-366-7691
Practice Address - Street 1:2510 BALDWICK RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4104
Practice Address - Country:US
Practice Address - Phone:412-922-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000495L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist