Individual
MRS. JENNIFER ANN FACKELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
42 NORBROOK RD, FAIRPORT, NY 14450-8958
(585) 797-9366
(585) 486-1230
Mailing address
42 NORBROOK RD, FAIRPORT, NY 14450-8958
(585) 797-9366
(585) 486-1230
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
008637-1
NY
Other
Enumeration date
01/27/2009
Last updated
01/27/2009
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