Provider Demographics
NPI:1639291818
Name:SCHAFFER, KATHLEEN J (COTAL)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:J
Last Name:SCHAFFER
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-1626
Mailing Address - Country:US
Mailing Address - Phone:610-261-0376
Mailing Address - Fax:
Practice Address - Street 1:600 S BROAD ST
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3346
Practice Address - Country:US
Practice Address - Phone:610-925-4290
Practice Address - Fax:610-347-6233
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP000732L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant