Provider Demographics
NPI:1578162053
Name:EBERLY, EMILY JEAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JEAN
Last Name:EBERLY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:HOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:169 STRASBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1323
Mailing Address - Country:US
Mailing Address - Phone:717-575-5144
Mailing Address - Fax:
Practice Address - Street 1:785 CHERRY TREE CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7902
Practice Address - Country:US
Practice Address - Phone:717-316-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016902225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist