Provider Demographics
NPI:1851913594
Name:CHIGUMIRA, CHIDO BRIDGET
Entity Type:Individual
Prefix:
First Name:CHIDO
Middle Name:BRIDGET
Last Name:CHIGUMIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 SUMMER LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8087
Mailing Address - Country:US
Mailing Address - Phone:610-718-6262
Mailing Address - Fax:
Practice Address - Street 1:ONE VETERANS DR
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475
Practice Address - Country:US
Practice Address - Phone:610-948-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC016596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty