Individual
JENIFER M HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
700 S HENDERSON RD, SUITE 200, KING OF PRUSSIA, PA 19406-3530
(610) 768-5940
(610) 768-5947
Mailing address
PO BOX 5228, WEST CHESTER, PA 19380-0405
(610) 359-5672
(610) 359-1519
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC002624L
PA
225XH1200X
Hand Occupational Therapist
Primary
OC002624L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1452937
PERSONAL CHOICE
PA
01
—
2138776000
IBC - KEYSTONE
PA
Enumeration date
05/16/2007
Last updated
03/13/2023
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