Provider Demographics
NPI:1508480476
Name:LIFE WELLNESS OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:LIFE WELLNESS OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:215-518-8585
Mailing Address - Street 1:2223 BERWYN CT
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4667
Mailing Address - Country:US
Mailing Address - Phone:215-518-8585
Mailing Address - Fax:
Practice Address - Street 1:2223 BERWYN CT
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4667
Practice Address - Country:US
Practice Address - Phone:215-518-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty