Provider Demographics
NPI:1831828375
Name:FOGLE, ELIZABETH NICOLE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:NICOLE
Last Name:FOGLE
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 1:33401 ROUTE 35 N
Mailing Address - Street 2:
Mailing Address - City:MC ALISTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17049-8186
Mailing Address - Country:US
Mailing Address - Phone:717-364-7220
Mailing Address - Fax:
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-248-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist