Individual
DIANE MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
111 PERRYMONT RD, PITTSBURGH, PA 15237-5246
(412) 366-5600
Mailing address
111 PERRYMONT RD, PITTSBURGH, PA 15237-5246
(412) 366-5600
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
OP000668L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP000668L
STATE LICENCE
PA
Enumeration date
03/23/2019
Last updated
03/23/2019
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