Individual
MRS. JACQUELYN ELIZABETH COMERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 963-1278
(570) 963-1292
Mailing address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 963-1278
(570) 963-1292
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009300
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011362020001
—
PA
Enumeration date
10/06/2006
Last updated
07/08/2007
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