Provider Demographics
NPI:1013156090
Name:ROTHER, MARY ANN ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:ELIZABETH
Last Name:ROTHER
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 1:1086 STATE ROUTE 315 PLAZA
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-823-7761
Mailing Address - Fax:570-829-7761
Practice Address - Street 1:106 ROTARY DR
Practice Address - Street 2:
Practice Address - City:WEST HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1182
Practice Address - Country:US
Practice Address - Phone:570-459-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006315L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist