Individual
MRS. JENNIFER JOANNE DICRISCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
22 FREDRICK BLVD, SWEDESBORO, NJ 08085-4242
(856) 467-6939
Mailing address
22 FREDRICK BLVD, SWEDESBORO, NJ 08085-4242
(856) 467-6939
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00093100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QB00093100
STATE BOARD OF PHYSICAL THERAPY
NJ
Enumeration date
10/21/2008
Last updated
10/21/2008
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