Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1265995583 |
---|---|
Provider Name | Jaclyn Lippincott |
First Address | Newtown, PA 18940-1873 |
Second Address | Newtown, PA 18940-1873 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2019 |
Last Update Date | 12/04/2019 |