Provider Demographics
NPI:1740319557
Name:SWISHER, ANITA JOSEFA (COTAL)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:JOSEFA
Last Name:SWISHER
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:MISS
Other - First Name:ANITA
Other - Middle Name:JOSEFA
Other - Last Name:JAKOB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTAL
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:130 CENTRAL MANOR RD
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554
Mailing Address - Country:US
Mailing Address - Phone:717-285-4958
Mailing Address - Fax:
Practice Address - Street 1:2829 LITITZ PIKE
Practice Address - Street 2:LANCASHIRE HALL
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3321
Practice Address - Country:US
Practice Address - Phone:717-569-3211
Practice Address - Fax:717-569-1569
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP000236L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant