Provider Demographics
NPI:1346655263
Name:FARNAN, JILLIAN KATHLEEN (OTA)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:KATHLEEN
Last Name:FARNAN
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 WREXHAM CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4815
Mailing Address - Country:US
Mailing Address - Phone:215-964-0520
Mailing Address - Fax:
Practice Address - Street 1:1 SHEPHERDS WAY
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4201
Practice Address - Country:US
Practice Address - Phone:215-956-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATOP008774224Z00000X
PAOP008062224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant