Provider Demographics
NPI:1356550099
Name:DANCHO, BECKY LEE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:LEE
Last Name:DANCHO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 PALOMINO CIR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-9517
Mailing Address - Country:US
Mailing Address - Phone:610-751-4158
Mailing Address - Fax:610-599-8917
Practice Address - Street 1:39 PALOMINO CIR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-9517
Practice Address - Country:US
Practice Address - Phone:610-751-4158
Practice Address - Fax:610-599-8917
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC007176L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics