Provider Demographics
NPI:1588230106
Name:GORSUCH, TERRI LYNN (COTA/C)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:LYNN
Last Name:GORSUCH
Suffix:
Gender:F
Credentials:COTA/C
Other - Prefix:MRS
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:LINTON HARDESTER SHOUL ROTHENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 HARRISBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-393-1301
Mailing Address - Fax:
Practice Address - Street 1:1520 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-393-1301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP009823224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant