Individual
MARIANN BEVENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1125 LAFAYETTE RD, WAYNE, PA 19087-2110
(610) 293-0343
Mailing address
1125 LAFAYETTE RD, WAYNE, PA 19087-2110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC003796L
PA
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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