Provider Demographics
NPI:1447402797
Name:BICKHAM, JANINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:BICKHAM
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:PO BOX 25
Mailing Address - Street 2:PEDIATRIC OT SOLUTIONS
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930
Mailing Address - Country:US
Mailing Address - Phone:845-827-5360
Mailing Address - Fax:845-827-5361
Practice Address - Street 1:615 RTE 32
Practice Address - Street 2:PEDIATRIC OT SOLUTIONS
Practice Address - City:HIGHLAND MILLS
Practice Address - State:NY
Practice Address - Zip Code:10930
Practice Address - Country:US
Practice Address - Phone:845-827-5360
Practice Address - Fax:845-827-5361
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4615225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist