Individual
LORI DECARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
696A LENNI RD, ASTON, PA 19014-1066
(610) 459-2046
Mailing address
696A LENNI RD, ASTON, PA 19014-1066
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
OP001599L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP001599L
AOTA
PA
Enumeration date
09/15/2009
Last updated
09/15/2009
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