Individual
MEGAN PHENNICIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
208 PENNKNOLL RD, EVERETT, PA 15537-6940
(814) 623-3200
Mailing address
609 SHOUP ST, SAXTON, PA 16678-1036
(814) 494-7605
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP008922
PA
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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