Individual
JUDI MAURA RENCAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24-2 KINGSWOOD DR, DALLAS, PA 18612-1404
(570) 674-7711
Mailing address
24-2 KINGSWOOD DR, DALLAS, PA 18612-1404
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC003375L
PA
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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