Provider Demographics
NPI:1558377416
Name:SPEAKMAN, TERI J (OTR L CHT)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:J
Last Name:SPEAKMAN
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:J
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR L
Mailing Address - Street 1:PO BOX 34990
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0627
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:
Practice Address - Street 1:4 INDUSTRIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1614
Practice Address - Country:US
Practice Address - Phone:610-768-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004551L225XH1200X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
0401979000OtherPERSONAL CHOICE 65
062877Medicare ID - Type Unspecified
PA062897QZYMedicare ID - Type Unspecified