Provider Demographics
NPI:1801559539
Name:PAUP, MARY KATE (OTR/L)
Entity type:Individual
Prefix:
First Name:MARY KATE
Middle Name:
Last Name:PAUP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARY KATE
Other - Middle Name:
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3686 GREEN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1186
Mailing Address - Country:US
Mailing Address - Phone:609-477-9074
Mailing Address - Fax:
Practice Address - Street 1:777 FERRY RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2102
Practice Address - Country:US
Practice Address - Phone:800-992-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017774225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist