Provider Demographics
NPI:1063532588
Name:NOWICKI, BETH ANN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:NOWICKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95
Mailing Address - Street 2:2333 ROCKLAND ROAD
Mailing Address - City:CRANBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:16319-0095
Mailing Address - Country:US
Mailing Address - Phone:814-676-9267
Mailing Address - Fax:
Practice Address - Street 1:2775 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2760
Practice Address - Country:US
Practice Address - Phone:412-357-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008737225X00000X, 225X00000X
DC225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist