Provider Demographics
NPI:1265943823
Name:DULLINGER, JAMIE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:DULLINGER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:BAUMGARDNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:6627 RIDGEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-1810
Practice Address - Country:US
Practice Address - Phone:717-808-6169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-22
Last Update Date:2017-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015241225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist