Individual
MRS. JO ANN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3975 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5426
(215) 879-1000
(215) 879-3912
Mailing address
117 CHURCH ST, NORTH WALES, PA 19454-2941
(215) 699-7320
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC001578L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008465610001
—
PA
Enumeration date
04/02/2007
Last updated
07/08/2007
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