Provider Demographics
NPI:1356612725
Name:CHAPIN, BERNADETTE K
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:K
Last Name:CHAPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 S HAVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-8118
Mailing Address - Country:US
Mailing Address - Phone:561-641-3130
Mailing Address - Fax:
Practice Address - Street 1:2939 S HAVERHILL RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-8118
Practice Address - Country:US
Practice Address - Phone:561-641-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA542224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant