Provider Demographics
NPI:1699989624
Name:ALSPACH, BONNIE KAYE (OTR)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:KAYE
Last Name:ALSPACH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:KAYE
Other - Last Name:LATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:546 BERWIN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-1512
Mailing Address - Country:US
Mailing Address - Phone:412-563-1193
Mailing Address - Fax:
Practice Address - Street 1:231 CROWE AVE
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:724-625-4280
Practice Address - Fax:724-625-4288
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004855L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist