Individual
JUSTINE TIDMARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
201 JUNIPER RD, HAVERTOWN, PA 19083-5411
(610) 908-5095
(855) 232-8604
Mailing address
201 JUNIPER RD, HAVERTOWN, PA 19083-5411
(610) 908-5095
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012414
PA
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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