Provider Demographics
NPI:1487950580
Name:MOYER, SANDRA REGINA (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:REGINA
Last Name:MOYER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 NEWPORT CIRCLE WEST
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:215-396-1051
Mailing Address - Fax:215-322-6997
Practice Address - Street 1:518 NEWPORT CIR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19053-2489
Practice Address - Country:US
Practice Address - Phone:215-396-1051
Practice Address - Fax:215-322-6997
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011455225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist