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General NPI Number Information
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NPI Number | 1083433908
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Entity Type | Individual
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Provider Name | JADA N HINES
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 301 E CITY LINE AVE STE 110
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1738
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Country | US
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Telephone | 610-904-3637
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Fax |
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Provider Business Mailing Address
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Address Line | 3029 PORTER RD
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City | CAMDEN
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State | NJ
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Zip | 08104-2708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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