Provider Demographics
NPI:1174869846
Name:DARKOWSKI, MARIANE LISA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MARIANE
Middle Name:LISA
Last Name:DARKOWSKI
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 BLOSSOM DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236
Mailing Address - Country:US
Mailing Address - Phone:412-653-1386
Mailing Address - Fax:
Practice Address - Street 1:448 BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-2431
Practice Address - Country:US
Practice Address - Phone:412-653-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP000735L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant