Provider Demographics
NPI:1891957049
Name:ZEGER, MELINDA PEARL (COTA/L)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:PEARL
Last Name:ZEGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:PEARL
Other - Last Name:EBERSOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:815 FERN LN
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-8629
Mailing Address - Country:US
Mailing Address - Phone:717-261-4174
Mailing Address - Fax:717-261-1092
Practice Address - Street 1:5500 BROOKTREE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:180-067-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002432L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant