Provider Demographics
NPI:1861121246
Name:O'CONNELL, JOSHUA (OTR/L)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:M
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 1:353 N DUFFY RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1138
Mailing Address - Country:US
Mailing Address - Phone:570-985-8222
Mailing Address - Fax:
Practice Address - Street 1:353 N DUFFY RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1138
Practice Address - Country:US
Practice Address - Phone:570-985-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017113225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation