Provider Demographics
NPI:1497170773
Name:MEISENBACH, THERESA ANNE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANNE
Last Name:MEISENBACH
Suffix:
Gender:F
Credentials:COTA/L
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Mailing Address - Street 1:1817 OLDE HOMESTEAD LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6751
Mailing Address - Country:US
Mailing Address - Phone:717-394-3466
Mailing Address - Fax:717-394-1252
Practice Address - Street 1:1817 OLDE HOMESTEAD LN
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6751
Practice Address - Country:US
Practice Address - Phone:717-394-3466
Practice Address - Fax:717-394-1252
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOP006422224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant