Basic Information
| Provider Information | |||||||||
| NPI: | 1740543040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHRONINGER | ||||||||
| FirstName: | BETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 03311 CO. RD. S | ||||||||
| Address2: | |||||||||
| City: | EDON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7409755925 | ||||||||
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| Practice Location | |||||||||
| Address1: | 64 DANBURY RD | ||||||||
| Address2: | |||||||||
| City: | WILTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002780332 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2012 | ||||||||
| LastUpdateDate: | 06/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 0131000921 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
ID Information
| ID | Type | State | Issuer | Description | 0131000921 | 01 | VA | STATE OF VIRGINIA | OTHER |