Individual
MRS. JILL THERESA WABS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1412 LANSDOWNE AVE, DARBY, PA 19023-1218
(610) 461-6510
Mailing address
5774 IRVING AVE, PENNSAUKEN, NJ 08109-5321
(856) 663-5504
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003562L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP003562L
LICENSE
PA
Enumeration date
04/17/2007
Last updated
07/08/2007
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