Individual
ELISSA ANN GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTRL
Contact information
Practice address
500 PHILADELPHIA AVE, SHILLINGTON, PA 19607-2764
(610) 796-7022
Mailing address
107 COLONIAL DR APT B, SHILLINGTON, PA 19607-2889
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009909
PA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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