Basic Information
| Provider Information | |||||||||
| NPI: | 1932474699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HINES | ||||||||
| FirstName: | TOYA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 810 W PENN PINES BLVD | ||||||||
| Address2: | |||||||||
| City: | ALDAN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190184311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103942528 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1930 S BROAD ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191452328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153394563 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2012 | ||||||||
| LastUpdateDate: | 03/14/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC008690 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225XG0600X | OC008690 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology | 225XP0019X | OC008690 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No ID Information.