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General NPI Number Information
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NPI Number | 1295934834
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Entity Type | Individual
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Provider Name | JESSICA EDEN HUDNALL OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 123 FIVE POINTS RICHMOND RD
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City | BANGOR
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State | PA
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Zip | 18013-5224
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Country | US
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Telephone | 610-599-7015
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Fax |
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Provider Business Mailing Address
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Address Line | 318 CRESTMONT ST
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City | PEN ARGYL
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State | PA
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Zip | 18072-9680
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Country | US
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Telephone | 610-248-2686
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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 | OC021133
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License Number State | PA
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