Provider Demographics
NPI:1629284153
Name:BURROUGHS, ANNE GRACE
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:GRACE
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WINDGATE DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7515
Mailing Address - Country:US
Mailing Address - Phone:724-933-8082
Mailing Address - Fax:724-933-8082
Practice Address - Street 1:CELTIC REHABILITATION
Practice Address - Street 2:231 CROWE AVENUE
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:724-625-4280
Practice Address - Fax:724-625-4288
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005434L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist