Provider Demographics
NPI:1720323207
Name:MARTINELLI, LAUREEN J (OTR/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREEN
Middle Name:J
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:OTR/SLP
Other - Prefix:MISS
Other - First Name:LAUREEN
Other - Middle Name:J
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/SLP
Mailing Address - Street 1:413 SPRING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1453
Mailing Address - Country:US
Mailing Address - Phone:717-712-3914
Mailing Address - Fax:
Practice Address - Street 1:5225 WILSON LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6663
Practice Address - Country:US
Practice Address - Phone:717-591-8063
Practice Address - Fax:717-697-6576
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC0002731225X00000X
PASL003038L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396822Medicare Oscar/Certification