Provider Demographics
NPI:1972323640
Name:MOONEY, ERIN (OTR/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MOONEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 MAPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1200
Mailing Address - Country:US
Mailing Address - Phone:484-624-2999
Mailing Address - Fax:
Practice Address - Street 1:1378 RED DALE RD
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-9464
Practice Address - Country:US
Practice Address - Phone:570-573-3293
Practice Address - Fax:570-227-1983
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC020233225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist