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Individual

CRISTINA GRACE VANBROCKLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-5511
Mailing address
136 WELSH DR APT A, LANCASTER, PA 17601-2465
(301) 526-6388

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
09218
MD
225X00000X
Occupational Therapist
Primary
OC018051
PA
225X00000X
Occupational Therapist
OT010001821
DC

Other

Enumeration date
03/21/2021
Last updated
01/20/2022
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