Individual
JENNIFER ELIZABETH BROUGHTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
10 SHERMAN ST, WELLSBORO, PA 16901-1829
(570) 724-1811
Mailing address
327 NAUVOO RD, MORRIS, PA 16938-9568
(570) 353-2718
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003316L
PA
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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