Provider Demographics
NPI:1801629316
Name:MCGOWAN, PAYTON (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WESTINGHOUSE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5238
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:
Practice Address - Street 1:16515 POTTSVILLE PIKE STE B
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-8182
Practice Address - Country:US
Practice Address - Phone:484-660-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC020174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist