MEDICARE: JESSICA DRASS ATR-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist

General Provider Information

NPI Number	:	1326585357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DRASS ATR-BC

Provider Business Mailing Address
First Line	:	308 PAVONIA CIR
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-5914
Country	:	US
Telephone Number	:	609-213-0699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 WHITE HORSE PIKE
Second Line	:
City	:	HADDON TOWNSHIP
State	:	NJ
Zip	:	08107-1065
Country	:	US
Telephone Number	:	609-213-0699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2017
Last Update Date	:	01/29/2017

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