Individual
MRS. JENNIFER MAISANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2509 S 4TH ST, PHILADELPHIA, PA 19148-4712
(215) 271-1080
Mailing address
412 S ELMWOOD AVE, GLENOLDEN, PA 19036-2327
(610) 583-2977
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003537L
PA
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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