Provider Demographics
NPI:1154007326
Name:CHANDLER, ERICA (OTR/L, CLWT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:OTR/L, CLWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14663 ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:SLIGO
Mailing Address - State:PA
Mailing Address - Zip Code:16255-2231
Mailing Address - Country:US
Mailing Address - Phone:814-745-2031
Mailing Address - Fax:
Practice Address - Street 1:14663 ROUTE 68
Practice Address - Street 2:
Practice Address - City:SLIGO
Practice Address - State:PA
Practice Address - Zip Code:16255-2231
Practice Address - Country:US
Practice Address - Phone:814-745-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016316225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist