Provider Demographics
NPI:1871262303
Name:WEIDNER, ERIN ROSE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ROSE
Last Name:WEIDNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MONUMENT RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5023
Mailing Address - Country:US
Mailing Address - Phone:717-812-6486
Mailing Address - Fax:
Practice Address - Street 1:55 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5023
Practice Address - Country:US
Practice Address - Phone:717-812-6486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist