Individual
JOLIZA GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9440 LEGION ST, PHILADELPHIA, PA 19114-2607
(267) 570-7823
Mailing address
9440 LEGION ST, PHILADELPHIA, PA 19114-2607
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC019093
PA
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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