Provider Demographics
NPI:1437523909
Name:BELLARDO, NATALIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BELLARDO
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 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3529
Mailing Address - Country:US
Mailing Address - Phone:814-706-7281
Mailing Address - Fax:
Practice Address - Street 1:12 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:PA
Practice Address - Zip Code:16345-1130
Practice Address - Country:US
Practice Address - Phone:814-706-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-21
Last Update Date:2015-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007086224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant