Provider Demographics
NPI:1225399827
Name:ANDERSON, BERNADETTE WILK (OTR/L)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:WILK
Last Name:ANDERSON
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 1:244 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3512
Mailing Address - Country:US
Mailing Address - Phone:717-291-5951
Mailing Address - Fax:717-291-9183
Practice Address - Street 1:244 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3512
Practice Address - Country:US
Practice Address - Phone:717-291-5951
Practice Address - Fax:717-291-9183
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000894L225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision