Provider Demographics
NPI:1861992356
Name:MACRONE-WOJTON, MINDY (DSC, OTR/L)
Entity type:Individual
Prefix:DR
First Name:MINDY
Middle Name:
Last Name:MACRONE-WOJTON
Suffix:
Gender:F
Credentials:DSC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 OLD STATE RD
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-3215
Mailing Address - Country:US
Mailing Address - Phone:610-792-1986
Mailing Address - Fax:
Practice Address - Street 1:1378 RED DALE RD
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9464
Practice Address - Country:US
Practice Address - Phone:570-573-3293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004853L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics