Individual
MICHELE FENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1000 MILL ST, DUNMORE, PA 18512
(570) 342-7624
Mailing address
1000 MILL ST, DUNMORE, PA 18512-3069
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
07/31/2017
Last updated
07/31/2017
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