Provider Demographics
NPI:1568917102
Name:RITTER, DIANA ROSE MITCHELL (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:ROSE MITCHELL
Last Name:RITTER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2229
Mailing Address - Country:US
Mailing Address - Phone:717-576-4524
Mailing Address - Fax:
Practice Address - Street 1:839 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2229
Practice Address - Country:US
Practice Address - Phone:717-576-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014572225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist