Individual
JENNIFER FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10098320-4201
UT
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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