Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OC006222L | PA |
NPI | 1033277363 |
---|---|
Provider Name | Jennifer Lynn Magulick |
First Address | Sarver, PA 16055-9570 |
Second Address | Lower Burrell, PA 15068-3138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 03/10/2014 |