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Individual

MS. LENNISA CHERYL SHABAZZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 546-5960
Mailing address
7120 ARDLEIGH ST APT E, PHILADELPHIA, PA 19119-1205
(315) 956-0493

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012544
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OC012544
NBCOT
PA
Enumeration date
04/25/2013
Last updated
04/25/2013
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