Provider Demographics
NPI:1124389499
Name:WATRAL, MARY KATHERINE
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:KATHERINE
Last Name:WATRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800B MCKNIGHT RD STE 150
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6014
Mailing Address - Country:US
Mailing Address - Phone:412-364-2446
Mailing Address - Fax:
Practice Address - Street 1:9800B MCKNIGHT RD STE 150
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6014
Practice Address - Country:US
Practice Address - Phone:412-364-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015293225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist