Provider Demographics
NPI:1942066923
Name:MCFADDEN, ALYSON NOEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:NOEL
Last Name:MCFADDEN
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 1:784 W MAIN ST APT 1
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1804
Mailing Address - Country:US
Mailing Address - Phone:724-562-4351
Mailing Address - Fax:
Practice Address - Street 1:784 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1804
Practice Address - Country:US
Practice Address - Phone:724-562-4351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist