Provider Demographics
NPI:1053434068
Name:CAMPBELL, PATRICIA ANN SHERMAN (OTRL)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN SHERMAN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 BEAUMONT DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1366
Mailing Address - Country:US
Mailing Address - Phone:610-932-4074
Mailing Address - Fax:
Practice Address - Street 1:301 MCKINLY LAB
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-831-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEUI-0000810225X00000X
PAOC009273225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist