Provider Demographics
NPI:1396493763
Name:SPENCER, APRIL ANN (COTA/L)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:ANN
Last Name:SPENCER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SHORT LN
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18426-7557
Mailing Address - Country:US
Mailing Address - Phone:570-766-1852
Mailing Address - Fax:
Practice Address - Street 1:1404 GOLF PARK DR
Practice Address - Street 2:
Practice Address - City:LAKE ARIEL
Practice Address - State:PA
Practice Address - Zip Code:18436-4252
Practice Address - Country:US
Practice Address - Phone:570-698-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010215224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant