Provider Demographics
NPI:1790853364
Name:SKIRVEN, THERESE M (OT)
Entity type:Individual
Prefix:MS
First Name:THERESE
Middle Name:M
Last Name:SKIRVEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:THERESE
Other - Middle Name:M
Other - Last Name:SKIRVEN-DIGIORGIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 34990
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0627
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:
Practice Address - Street 1:834 CHESTNUT ST
Practice Address - Street 2:SUITE G114
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5127
Practice Address - Country:US
Practice Address - Phone:215-521-3000
Practice Address - Fax:215-521-3002
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000553L225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1452888OtherIBC - PERSONAL CHOICE
PA2138758000OtherIBC - KEYSTONE