Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP001557L | PA |
NPI | 1013168863 |
---|---|
Provider Name | Mrs. Jennifer Lynn Fisher |
First Address | Devon, PA 19333-1560 |
Second Address | Devon, PA 19333-1560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 09/10/2008 |