Individual
JENNIFER R CAPOBIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
250 CETRONIA ROAD, SUITE 303, ALLENTOWN, PA 18104-9168
(610) 973-6200
(610) 973-6535
Mailing address
PO BOX 848269, BOSTON, MA 02284-8269
(610) 973-1700
(610) 973-1778
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC004237L
PA
225XH1200X
Hand Occupational Therapist
Primary
OC004237L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094433
MEDICARE
PA
01
—
50044642
BLUE CROSS
PA
Enumeration date
09/21/2005
Last updated
07/31/2009
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