Provider Demographics
NPI:1801584214
Name:MAKOLA, ALAIN LUBUNGA (OTA)
Entity type:Individual
Prefix:MR
First Name:ALAIN
Middle Name:LUBUNGA
Last Name:MAKOLA
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:350 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8329
Mailing Address - Country:US
Mailing Address - Phone:724-914-5743
Mailing Address - Fax:
Practice Address - Street 1:113 W MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2427
Practice Address - Country:US
Practice Address - Phone:724-941-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007200224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant