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Individual

MRS. KARA JANELLE FAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA L

Contact information

Practice address
336 S WEST END AVE, LANCASTER, PA 17603-5043
(717) 393-0419
Mailing address
223 HEATHER LN, EPHRATA, PA 17522-2808
(717) 799-3895

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006222
PA

Other

Enumeration date
03/15/2007
Last updated
07/08/2007
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