Provider Demographics
NPI:1730653700
Name:GRIFFIN, MARIA A (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9481
Mailing Address - Country:US
Mailing Address - Phone:610-906-4251
Mailing Address - Fax:
Practice Address - Street 1:530 MACOBY ST
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1112
Practice Address - Country:US
Practice Address - Phone:215-679-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008741225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist