Provider Demographics
NPI:1871376244
Name:NEGLEY, ERICA JEAN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JEAN
Last Name:NEGLEY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SAINT PHILLIPS CT
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3168
Mailing Address - Country:US
Mailing Address - Phone:724-594-5351
Mailing Address - Fax:
Practice Address - Street 1:105 S PIKE RD
Practice Address - Street 2:
Practice Address - City:SARVER
Practice Address - State:PA
Practice Address - Zip Code:16055-9283
Practice Address - Country:US
Practice Address - Phone:724-353-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019289225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist