Provider Demographics
NPI:1235302092
Name:CHMIELEWSKI, JAMIE (COTA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LEHIGH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3880
Mailing Address - Country:US
Mailing Address - Phone:610-289-0114
Mailing Address - Fax:
Practice Address - Street 1:1040 LIGGETT AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1801
Practice Address - Country:US
Practice Address - Phone:610-775-1431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006501224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant