Provider Demographics
NPI:1962630665
Name:SPAYD, BRIDGET DELELLIS (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:DELELLIS
Last Name:SPAYD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MS
Other - First Name:BRIDGET
Other - Middle Name:DELELLIS
Other - Last Name:CAHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:28-14 DREXELBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-5303
Mailing Address - Country:US
Mailing Address - Phone:610-329-5533
Mailing Address - Fax:
Practice Address - Street 1:549 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1020
Practice Address - Country:US
Practice Address - Phone:610-558-7417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006596224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant