Individual
MRS. JENNIFER L PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 STANLEY ST, BECKLEY, WV 25801-5745
(304) 906-9418
Mailing address
113 STANLEY ST, BECKLEY, WV 25801-5745
(304) 906-9418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1715
WV
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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