Provider Demographics
NPI:1710571476
Name:WAIGHT, MADELINE ANNE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MADELINE
Middle Name:ANNE
Last Name:WAIGHT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 CALMAR DR
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-5002
Mailing Address - Country:US
Mailing Address - Phone:412-715-8497
Mailing Address - Fax:
Practice Address - Street 1:1036 CALMAR DR
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-5002
Practice Address - Country:US
Practice Address - Phone:412-715-8497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017349225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist