Provider Demographics
NPI:1598881955
Name:HEALY, ANNA M (OTR)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:HEALY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7823 FLOURTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8012
Mailing Address - Country:US
Mailing Address - Phone:215-402-0925
Mailing Address - Fax:
Practice Address - Street 1:6300 GREENE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2510
Practice Address - Country:US
Practice Address - Phone:215-844-0700
Practice Address - Fax:215-843-0369
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOCOO1683L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC001683LOtherLICENSE