Provider Demographics
NPI:1013627595
Name:COLEMAN, KARLEY (MOTR/L)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FIRMIN WAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9409
Mailing Address - Country:US
Mailing Address - Phone:717-451-4658
Mailing Address - Fax:
Practice Address - Street 1:8420 GAS HOUSE PIKE STE U
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4974
Practice Address - Country:US
Practice Address - Phone:240-651-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018877225X00000X
MD09821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist