Provider Demographics
NPI:1821053273
Name:SCARSELLA, HEIDI M (OTR/L)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:M
Last Name:SCARSELLA
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 1:401 LOCUST STREET
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3954
Mailing Address - Country:US
Mailing Address - Phone:412-299-0704
Mailing Address - Fax:412-299-2823
Practice Address - Street 1:401 LOCUST STREET
Practice Address - Street 2:SUITE 2A
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-3954
Practice Address - Country:US
Practice Address - Phone:412-299-0704
Practice Address - Fax:412-299-2823
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC007150L225X00000X, 225XP0200X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001898621Medicaid
PA0018986210007Medicaid