Provider Demographics
NPI:1154585685
Name:SCREVEN, TIMIKA E (PT)
Entity type:Individual
Prefix:DR
First Name:TIMIKA
Middle Name:E
Last Name:SCREVEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 N 10TH ST APT 518
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3826
Mailing Address - Country:US
Mailing Address - Phone:614-477-0011
Mailing Address - Fax:
Practice Address - Street 1:6201 N 10TH ST APT 518
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3826
Practice Address - Country:US
Practice Address - Phone:614-477-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297794225100000X
PAPT019406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist