Provider Demographics
NPI:1770734246
Name:CONLEY-FERRIS, EILEEN F (COTA)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:F
Last Name:CONLEY-FERRIS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8717
Mailing Address - Country:US
Mailing Address - Phone:724-934-1368
Mailing Address - Fax:
Practice Address - Street 1:155 LAKE DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8406
Practice Address - Country:US
Practice Address - Phone:724-624-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP002660L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant