Individual
JENNIFER A BARILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
590 GRAVITY ROAD, LAKE ARIEL, PA 18436-4136
(570) 647-8445
(570) 647-8445
Mailing address
590 GRAVITY RD, LAKE ARIEL, PA 18436-4136
(570) 647-8445
(570) 647-8445
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC005834L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
843516
MANAGED PHYSICIAN NETWORK
NY
01
—
843516
MANAGED PHYSICIAN NETWORK
PA
Enumeration date
08/30/2005
Last updated
09/22/2011
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