Provider Demographics
NPI:1891743738
Name:STRUB, NANCY L (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:STRUB
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 OLD FORGE XING
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1122
Mailing Address - Country:US
Mailing Address - Phone:610-688-2969
Mailing Address - Fax:
Practice Address - Street 1:744 W LANCASTER AVE
Practice Address - Street 2:STE. 125
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2523
Practice Address - Country:US
Practice Address - Phone:610-688-7776
Practice Address - Fax:610-688-4117
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C000557225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist