Individual
JESSICA TYRRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38 W 32ND ST STE 604, NEW YORK, NY 10001-3884
(201) 282-9553
Mailing address
110 RICHMOND ST, LODI, NJ 07644-2817
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
019580-1
NY
Other
Enumeration date
05/02/2015
Last updated
05/02/2015
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