Provider Demographics
NPI:1245788280
Name:GREEN, BETSY (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:J
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:250 CETRONIA RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9147
Mailing Address - Country:US
Mailing Address - Phone:610-674-4911
Mailing Address - Fax:
Practice Address - Street 1:250 CETRONIA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9147
Practice Address - Country:US
Practice Address - Phone:610-674-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003575L225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist