Individual
MS. LAUREN M. DETULLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
950 PULASKI DR STE 100, KING OF PRUSSIA, PA 19406-2802
(610) 768-4460
(610) 768-5947
Mailing address
950 PULASKI DR STE 100, KING OF PRUSSIA, PA 19406-2802
(484) 685-4801
(610) 768-5947
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC008942
PA
225XH1200X
Hand Occupational Therapist
Primary
OC008942
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1495761
IBC - PERSONAL CHOICE
PA
01
—
2184913000
IBC - KEYSTONE
PA
Enumeration date
11/29/2006
Last updated
03/01/2023
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