Provider Demographics
NPI:1265030837
Name:YURKANIN, JACQUELINE ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:ELIZABETH
Last Name:YURKANIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:ELIZABETH
Other - Last Name:STRAUSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-0241
Mailing Address - Country:US
Mailing Address - Phone:570-336-0309
Mailing Address - Fax:272-207-2774
Practice Address - Street 1:311 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:PA
Practice Address - Zip Code:18644-1620
Practice Address - Country:US
Practice Address - Phone:570-336-0309
Practice Address - Fax:272-207-2774
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017150225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist