Individual
MARY PINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
616 PINE ST APT 3, HOLLIDAYSBURG, PA 16648-2157
(570) 594-0885
Mailing address
616 PINE ST APT 3, HOLLIDAYSBURG, PA 16648-2157
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
314000000X
Skilled Nursing Facility
OP000791L
PA
Other
Enumeration date
08/04/2014
Last updated
05/17/2019
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