Provider Demographics
NPI:1053579755
Name:CALLEN, JAMIE DAWN (OTR/L)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:DAWN
Last Name:CALLEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HARTMAN RD
Mailing Address - Street 2:SUITE #12 OAKLEY PARK
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7220
Mailing Address - Country:US
Mailing Address - Phone:724-836-3116
Mailing Address - Fax:724-836-3878
Practice Address - Street 1:143 HARTMAN RD
Practice Address - Street 2:SUITE #12 OAKLEY PARK
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7220
Practice Address - Country:US
Practice Address - Phone:724-836-3116
Practice Address - Fax:724-836-3878
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008528225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist