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NPI Code Detail

MEDICARE: DR. TERRI BUGELHOLL OTD OTR/L

MEDICARE: DR. TERRI BUGELHOLL OTD OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational TherapistOC015399PA

General Provider Information

NPI Number : 1952980542
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRI BUGELHOLL OTD OTR/L
Provider Business Mailing Address
First Line : 313 DELAWARE AVE
Second Line :
City : WEST PITTSTON
State : PA
Zip : 18643-2103
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1003 WYOMING AVE
Second Line :
City : FORTY FORT
State : PA
Zip : 18704-4002
Country : US
Telephone Number : 570-846-0455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2021
Last Update Date : 04/02/2021

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