Provider Demographics
NPI:1730277864
Name:BITER, JENNIFER LYNN (OTR L)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BITER
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 1:101 S PHANEY ST
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1641
Mailing Address - Country:US
Mailing Address - Phone:814-243-6788
Mailing Address - Fax:
Practice Address - Street 1:501 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-6410
Practice Address - Country:US
Practice Address - Phone:814-944-5014
Practice Address - Fax:814-944-6500
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010114225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000023490012Medicaid
PA396621Medicare ID - Type Unspecified