Provider Demographics
NPI:1487908828
Name:SCIARILLO, MARY LYNN (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:LYNN
Last Name:SCIARILLO
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 1:18 WOODY HILL EXT
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02808-1334
Mailing Address - Country:US
Mailing Address - Phone:401-474-5227
Mailing Address - Fax:
Practice Address - Street 1:18 WOODY HILL EXT
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:RI
Practice Address - Zip Code:02808-1334
Practice Address - Country:US
Practice Address - Phone:401-474-5227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01133225X00000X
CT003747225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist