Individual
JACKIE BROCIOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 E STANTON ST, PLAINS, PA 18705-3916
(570) 507-4682
Mailing address
19 E STANTON ST, PLAINS, PA 18705-3916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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