Individual
JESSICA DECRAENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 546-5960
Mailing address
5420 RIDGE AVE, PHILADELPHIA, PA 19128-3730
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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