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General NPI Number Information
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NPI Number | 1720522758
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Entity Type | Individual
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Provider Name | JACQUELYN REPICE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/09/2016
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 207 FLAGSTONE RD
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-3826
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Country | US
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Telephone | 610-241-2685
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Fax |
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Provider Business Mailing Address
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Address Line | 9801 GERMANTOWN PIKE APT 822
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-1102
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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 | OC014371
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License Number State | PA
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