Individual
DEIDRE PATRISSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATHLETIC TRAINER
Contact information
Practice address
10 SHUMAN RD, HONESDALE, PA 18431-2413
(570) 878-6663
Mailing address
10 SHUMAN RD, HONESDALE, PA 18431-2413
(570) 878-6661
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006125
PA
Other
Enumeration date
04/19/2020
Last updated
04/19/2020
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