Provider Demographics
NPI:1568891323
Name:LAWRENCE, JESSICA L (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:L
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2686
Mailing Address - Country:US
Mailing Address - Phone:443-624-7679
Mailing Address - Fax:
Practice Address - Street 1:NOVACARE REHABILITATION
Practice Address - Street 2:351 W. BEAU ST, SUITE B
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-228-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017366225X00000X
MD07272225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist