Provider Demographics
NPI:1992462451
Name:O'DONNELL, CASEY LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:LYNN
Last Name:O'DONNELL
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 1:102 HAMPTON CIR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-6347
Mailing Address - Country:US
Mailing Address - Phone:215-870-8238
Mailing Address - Fax:
Practice Address - Street 1:2003 LOWER STATE RD UNIT 312
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2622
Practice Address - Country:US
Practice Address - Phone:267-327-4276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist