Provider Demographics
NPI:1972818235
Name:MARONEY, COURTNEY (OTR/L)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MARONEY
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 1:73 STRATHMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-1734
Mailing Address - Country:US
Mailing Address - Phone:716-984-5304
Mailing Address - Fax:
Practice Address - Street 1:73 STRATHMORE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1734
Practice Address - Country:US
Practice Address - Phone:716-984-5304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113778225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist