Provider Demographics
NPI:1225362031
Name:BEVELHEIMER, CAROL LYNN (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LYNN
Last Name:BEVELHEIMER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 MAUS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2057
Mailing Address - Country:US
Mailing Address - Phone:724-863-9118
Mailing Address - Fax:724-863-8334
Practice Address - Street 1:249 MAUS DR
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2057
Practice Address - Country:US
Practice Address - Phone:724-863-9118
Practice Address - Fax:724-863-8334
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP005790224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant