Provider Demographics
NPI:1992753081
Name:MCCANN, ELLEN C (OTR/L, CHT)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:C
Last Name:MCCANN
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:N WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-2938
Mailing Address - Country:US
Mailing Address - Phone:609-523-8154
Mailing Address - Fax:
Practice Address - Street 1:801 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1265
Practice Address - Country:US
Practice Address - Phone:609-645-0505
Practice Address - Fax:609-641-3532
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00380700225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand