Individual
JACQUELYN AVERY ALFONSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8833 STENTON AVE, WYNDMOOR, PA 19038-8319
(215) 836-2100
Mailing address
200 REDFORD RD, ORELAND, PA 19075-1926
(215) 886-4815
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001877L
PA
Other
Enumeration date
04/05/2007
Last updated
07/08/2007
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