Individual
JENNIFER LAITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1574 THE HIDEOUT, LAKE ARIEL, PA 18436-9562
(302) 299-8496
Mailing address
1574 THE HIDEOUT, LAKE ARIEL, PA 18436-9562
(302) 299-8496
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP002949L
PA
Other
Enumeration date
09/28/2017
Last updated
07/21/2022
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