Provider Demographics
NPI:1154762102
Name:CROWDER, PATRICIA ELLEN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:CROWDER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 GREEN AVE EXT
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-9707
Mailing Address - Country:US
Mailing Address - Phone:717-242-1416
Mailing Address - Fax:
Practice Address - Street 1:276 GREEN AVE EXT
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-9707
Practice Address - Country:US
Practice Address - Phone:717-242-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP000824L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant