Provider Demographics
NPI:1598057226
Name:EDWARDS, CIEAYRHA HEATHER, PATRICE (COTA)
Entity Type:Individual
Prefix:MS
First Name:CIEAYRHA
Middle Name:HEATHER, PATRICE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COLONY BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1464
Mailing Address - Country:US
Mailing Address - Phone:302-762-5341
Mailing Address - Fax:
Practice Address - Street 1:800 W MINER ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2149
Practice Address - Country:US
Practice Address - Phone:610-738-3634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007060224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant