Individual
MRS. DENIQUE MARGARET THEUNISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1912 ALTER ST, PHILADELPHIA, PA 19146-2802
(610) 823-6604
Mailing address
1912 ALTER ST, PHILADELPHIA, PA 19146-2802
(610) 823-6604
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC011639
PA
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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