Provider Demographics
NPI:1447444534
Name:KULLEN, GERILYN MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:GERILYN
Middle Name:MARIE
Last Name:KULLEN
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 1:257 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-9740
Mailing Address - Country:US
Mailing Address - Phone:724-846-8200
Mailing Address - Fax:724-847-2998
Practice Address - Street 1:257 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-9740
Practice Address - Country:US
Practice Address - Phone:724-846-8200
Practice Address - Fax:724-847-2998
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006528L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist