Provider Demographics
NPI:1659605129
Name:CABLE, MARK HOWARD (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:HOWARD
Last Name:CABLE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3302 WEST LAKE WOODS
Mailing Address - Street 2:APARTMENT #126
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3667
Mailing Address - Country:US
Mailing Address - Phone:847-644-1280
Mailing Address - Fax:547-440-9000
Practice Address - Street 1:3302 WEST LAKE WOODS
Practice Address - Street 2:APARTMENT #126
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3667
Practice Address - Country:US
Practice Address - Phone:847-644-1280
Practice Address - Fax:547-440-9000
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2021-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
224Z00000X, 2251G0304X, 235Z00000X
IL056010180225X00000X
PAOC011206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist