Provider Demographics
NPI:1205950557
Name:MCCHESNEY, SHARON ANN (COTA)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:MCCHESNEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ANN
Other - Last Name:WIEAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 JAY LN
Mailing Address - Street 2:
Mailing Address - City:SPRING MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16875-7904
Mailing Address - Country:US
Mailing Address - Phone:814-422-8372
Mailing Address - Fax:
Practice Address - Street 1:17350 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:MILLMONT
Practice Address - State:PA
Practice Address - Zip Code:17845-9334
Practice Address - Country:US
Practice Address - Phone:570-922-3351
Practice Address - Fax:570-922-3391
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0P000128L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant