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General NPI Number Information
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NPI Number | 1376792887
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Entity Type | Individual
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Provider Name | VICTORIA LISSONG ADJEKPIYEDE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 701 FOULK RD STE 2A
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City | WILMINGTON
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State | DE
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Zip | 19803-3733
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Country | US
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Telephone | 877-407-3422
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 1ST AVE SUITE 381
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1334
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Country | US
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Telephone | 610-941-8089
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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 | OC010659
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License Number State | PA
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