Provider Demographics
NPI:1598075327
Name:EDENS, STEPHANIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:EDENS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 LOUCKS RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-7902
Mailing Address - Country:US
Mailing Address - Phone:717-885-0063
Mailing Address - Fax:717-885-0063
Practice Address - Street 1:1805 LOUCKS RD
Practice Address - Street 2:SUITE 800
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-7902
Practice Address - Country:US
Practice Address - Phone:717-885-0063
Practice Address - Fax:717-885-0063
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant