Provider Demographics
NPI:1558377416
Name:SPEAKMAN, TERI J (OTR L CHT)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:J
Last Name:SPEAKMAN
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:J
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR L
Mailing Address - Street 1:250 LANCASTER AVE
Mailing Address - Street 2:#225
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-651-8282
Mailing Address - Fax:610-651-8283
Practice Address - Street 1:250 LANCASTER AVE
Practice Address - Street 2:#225
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-651-8282
Practice Address - Fax:610-651-8283
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
0401979000OtherPERSONAL CHOICE 65
062877Medicare ID - Type Unspecified
PA062897QZYMedicare ID - Type Unspecified