Provider Demographics
NPI:1669623914
Name:SPIKER, CERIDWEN E (OTR/L)
Entity type:Individual
Prefix:
First Name:CERIDWEN
Middle Name:E
Last Name:SPIKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N MARKET ST APT 201
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-2040
Mailing Address - Country:US
Mailing Address - Phone:717-283-8022
Mailing Address - Fax:
Practice Address - Street 1:120 N MARKET ST APT 201
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-2040
Practice Address - Country:US
Practice Address - Phone:717-283-8022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009961225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist