Individual
MRS. LORI L GIACCHETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
97 WOODLAKE DR, MARLTON, NJ 08053-3617
(856) 745-6411
(856) 494-1322
Mailing address
97 WOODLAKE DR, MARLTON, NJ 08053-3617
(856) 745-6411
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09045300
NJ
224ZE0001X
Environmental Modification Occupational Therapy Assistant
46TA09045300
NJ
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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