Provider Demographics
NPI:1205421948
Name:EPSTEIN, ILANA (OT)
Entity type:Individual
Prefix:
First Name:ILANA
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1660
Mailing Address - Country:US
Mailing Address - Phone:215-478-1201
Mailing Address - Fax:
Practice Address - Street 1:8983 OKEECHOBEE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5145
Practice Address - Country:US
Practice Address - Phone:561-353-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21529225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist