Provider Demographics
NPI:1710700091
Name:METTEE, MADELINE MARIAN
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MARIAN
Last Name:METTEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 PACKARD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6418
Mailing Address - Country:US
Mailing Address - Phone:215-530-4311
Mailing Address - Fax:
Practice Address - Street 1:555 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3416
Practice Address - Country:US
Practice Address - Phone:215-293-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist