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General NPI Number Information
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NPI Number | 1669570883
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Entity Type | Individual
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Provider Name | JOEL HARTLAN DESOTELLE MS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 111 CHAMBERS HILL DR STE 101
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-7304
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Country | US
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Telephone | 717-709-7997
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Fax | 717-261-4725
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Provider Business Mailing Address
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Address Line | 111 CHAMBERS HILL DR STE 200
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-7304
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Country | US
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Telephone | 717-709-7922
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Fax | 717-263-2055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 04495
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OC008778
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OC008778
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OC008778
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License Number State | PA
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