Individual
AGNES VIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1628 JOHN F KENNEDY BLVD STE 401, PHILADELPHIA, PA 19103-2120
(215) 557-0057
Mailing address
1628 JOHN F KENNEDY BLVD STE 401, PHILADELPHIA, PA 19103-2120
(215) 557-0057
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC010928
PA
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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