Provider Demographics
NPI:1184446700
Name:FRESE, TAYLOR MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MARIE
Last Name:FRESE
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 1:108 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18955-1014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHLANDTOWN
Practice Address - State:PA
Practice Address - Zip Code:18955-1014
Practice Address - Country:US
Practice Address - Phone:267-371-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist