Healthcare Provider Details

I. General information

NPI: 1639941495
Provider Name (Legal Business Name): EMILY SPENCER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WESNER LN
DANVILLE PA
17821-8023
US

IV. Provider business mailing address

1607 FOWLER AVE
BERWICK PA
18603-1454
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-5314
  • Fax:
Mailing address:
  • Phone: 717-756-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC016077
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: