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Individual

MS. LISA M JOCHUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
254 OLD EAGLE SCHOOL RD, APT #1, WAYNE, PA 19087-2454
(610) 254-0184
Mailing address
254 OLD EAGLE SCHOOL RD, APT #1, WAYNE, PA 19087-2454
(610) 254-0184

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC001870L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254
PA
Enumeration date
09/05/2007
Last updated
09/08/2010
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