Individual
MRS. MYLENE MORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1404 HAY ST, BERLIN, PA 15530-1455
(814) 267-4212
(814) 267-6213
Mailing address
2346 PLANK RD, HOOVERSVILLE, PA 15936-7617
(814) 893-5523
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001290L
PA
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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