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Individual
MS. JOANNA KATHRINA REPOLLO PACA
Active
Individual
MS. JOANNA KATHRINA REPOLLO PACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
041207
NY
225200000X
Physical Therapy Assistant
013378
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013378
PTA LICENSE
NY
01
—
041207
LICENSE NUMBER
NY
Enumeration date
01/03/2023
Last updated
01/03/2023
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