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Individual

MRS. HOLLY L WISSNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
3023 WILMINGTON RD, NEW CASTLE, PA 16105
(724) 656-8814
(724) 656-8815
Mailing address
751 SHENANGO RD, BEAVER FALLS, PA 15010
(724) 891-7378
(724) 891-7378

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC004879L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1015390640001
MEDICAL ASSISTANCE NUMBER
PA
Enumeration date
03/26/2007
Last updated
07/08/2007
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