Healthcare Provider Details

I. General information

NPI: 1831974179
Provider Name (Legal Business Name): BRIDGET PAIGE ALLISON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 5TH ST
BROOKINGS OR
97415-9702
US

IV. Provider business mailing address

20 VIKING DR
LEWISTOWN PA
17044-1514
US

V. Phone/Fax

Practice location:
  • Phone: 541-412-2000
  • Fax:
Mailing address:
  • Phone: 717-348-2960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number477840
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: