Provider Demographics
NPI:1558837138
Name:CHICKA, JANET IRENE (OT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:IRENE
Last Name:CHICKA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GALLAGHER RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-4104
Mailing Address - Country:US
Mailing Address - Phone:610-944-4964
Mailing Address - Fax:847-386-5161
Practice Address - Street 1:590 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-9195
Practice Address - Country:US
Practice Address - Phone:610-944-4964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005479L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist