Provider Demographics
NPI:1518503663
Name:VOYACK, CHANTELLE (OT)
Entity type:Individual
Prefix:
First Name:CHANTELLE
Middle Name:
Last Name:VOYACK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CHANTELLE
Other - Middle Name:
Other - Last Name:BOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 WOODLAWN LN
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-4362
Mailing Address - Country:US
Mailing Address - Phone:717-448-8833
Mailing Address - Fax:
Practice Address - Street 1:801 N HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-1599
Practice Address - Country:US
Practice Address - Phone:717-249-5322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004329L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist