Individual
MRS. SAMANTHA RAVEN JACONETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
769 ROUTE 70 E STE C175, MARLTON, NJ 08053-2360
(609) 276-8553
Mailing address
50 JACKSON RD, BERLIN, NJ 08009-1611
(856) 287-5705
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09266200
NJ
Other
Enumeration date
05/02/2026
Last updated
05/02/2026
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