Provider Demographics
NPI:1225355878
Name:CHAMBERLIN-BACHMAN, LISA MARIE (MSOTR-L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:CHAMBERLIN-BACHMAN
Suffix:
Gender:F
Credentials:MSOTR-L
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:BACHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSOTR-L
Mailing Address - Street 1:220 BEAR RUN DR
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-1201
Mailing Address - Country:US
Mailing Address - Phone:570-578-7739
Mailing Address - Fax:
Practice Address - Street 1:185 S MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1921
Practice Address - Country:US
Practice Address - Phone:570-474-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008830225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist