Provider Demographics
NPI:1326131673
Name:STREISFELD, KARLY ANN (OTR)
Entity Type:Individual
Prefix:MISS
First Name:KARLY
Middle Name:ANN
Last Name:STREISFELD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 GREENTREE LN
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1220
Mailing Address - Country:US
Mailing Address - Phone:305-742-7220
Mailing Address - Fax:
Practice Address - Street 1:1212 GREENTREE LN
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-1220
Practice Address - Country:US
Practice Address - Phone:305-742-7220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 11930225X00000X
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist