Provider Demographics
NPI:1508220534
Name:EHLINGER, PATRICIA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:EHLINGER
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:PO BOX 503
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:NY
Mailing Address - Zip Code:13304-0503
Mailing Address - Country:US
Mailing Address - Phone:315-942-2012
Mailing Address - Fax:
Practice Address - Street 1:12592 POTATO HILL RD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:NY
Practice Address - Zip Code:13309-4840
Practice Address - Country:US
Practice Address - Phone:315-942-2012
Practice Address - Fax:315-942-2040
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001879-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant