Provider Demographics
NPI:1992354658
Name:MOSHER, CAROLINE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:MOSHER
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 1:12300 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8379
Mailing Address - Country:US
Mailing Address - Phone:724-933-4673
Mailing Address - Fax:
Practice Address - Street 1:3150 WASHINGTON RD STE 201
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-3189
Practice Address - Country:US
Practice Address - Phone:724-933-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016388225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics