Individual
BRANDI ALYSSA LICHTENWALNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1030 SPARROW WAY, BREINIGSVILLE, PA 18031-1662
(610) 387-6673
Mailing address
1030 SPARROW WAY, BREINIGSVILLE, PA 18031
(610) 554-4742
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006330
PA
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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