Individual
JESSICA STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
Mailing address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC014011
PA
Other
Enumeration date
01/14/2016
Last updated
04/09/2025
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