Individual
KRISTA JANINE GYDOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
30 WEST AVE, WAYNE, PA 19087-3322
(610) 293-2650
Mailing address
198 GLENWOOD RD, KING OF PRUSSIA, PA 19406-2530
(610) 239-6653
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008053
PA
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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