Provider Demographics
NPI:1386950459
Name:MERTZ, ANDREA L (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:L
Last Name:MERTZ
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHARLES ST
Mailing Address - Street 2:DANVILLE
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8517
Mailing Address - Country:US
Mailing Address - Phone:570-275-3146
Mailing Address - Fax:
Practice Address - Street 1:200 BERWICK RD
Practice Address - Street 2:ORANGEVILLE
Practice Address - City:ORANGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17859-9064
Practice Address - Country:US
Practice Address - Phone:570-683-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010474225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology