Individual
MISS BRIANNA MARIE BENNICI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 N SCOTT ST, CARBONDALE, PA 18407
(570) 282-1099
Mailing address
203 W LINE ST, OLYPHANT, PA 18447-2096
(570) 472-2063
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TOP009186
PA
Other
Enumeration date
01/28/2018
Last updated
05/31/2018
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