Individual
JESSICA JANSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
Contact information
Practice address
1103 MOUNTAINSIDE ROAD, CUMBOLA, PA 17930-0022
(570) 621-8794
Mailing address
1103 MOUNTAINSIDE ROAD, CUMBOLA, PA 17930-0022
(570) 621-8794
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC014777
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28636246
DRIVERS LICENSE
PA
Enumeration date
07/12/2017
Last updated
07/21/2022
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