Provider Demographics
NPI:1114235371
Name:ZIEGLER, LAURA BETH
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HAVEN LANE
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17846-9998
Mailing Address - Country:US
Mailing Address - Phone:570-458-5829
Mailing Address - Fax:570-458-5829
Practice Address - Street 1:200 BERWICK RD
Practice Address - Street 2:
Practice Address - City:ORANGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17859-9064
Practice Address - Country:US
Practice Address - Phone:570-458-5829
Practice Address - Fax:570-458-5829
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002939L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant