Provider Demographics
NPI:1003132176
Name:GROSSMAN, JOHANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:LIPINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1532 CUMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4823
Mailing Address - Country:US
Mailing Address - Phone:717-917-4892
Mailing Address - Fax:
Practice Address - Street 1:1541 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3335
Practice Address - Country:US
Practice Address - Phone:610-278-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010193225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist