Provider Demographics
NPI:1871804351
Name:PIATT, MERYTH ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:MERYTH
Middle Name:ANNE
Last Name:PIATT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MERYTH
Other - Middle Name:ANNE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:128 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-2946
Mailing Address - Country:US
Mailing Address - Phone:570-639-5231
Mailing Address - Fax:
Practice Address - Street 1:128 HEMLOCK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-2946
Practice Address - Country:US
Practice Address - Phone:570-592-3274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000428L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist