Provider Demographics
NPI:1104696129
Name:NORMAN, CALLIE E (COTA/L)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:E
Last Name:NORMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH VERSAILLES
Mailing Address - State:PA
Mailing Address - Zip Code:15137-1250
Mailing Address - Country:US
Mailing Address - Phone:412-667-0388
Mailing Address - Fax:
Practice Address - Street 1:800 ELSIE ST
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1470
Practice Address - Country:US
Practice Address - Phone:412-825-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant