Provider Demographics
NPI:1669138988
Name:MOGEL, JESSECA
Entity type:Individual
Prefix:
First Name:JESSECA
Middle Name:
Last Name:MOGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 FURNACE RD
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-9401
Mailing Address - Country:US
Mailing Address - Phone:484-818-2445
Mailing Address - Fax:
Practice Address - Street 1:627 FURNACE RD
Practice Address - Street 2:
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-9401
Practice Address - Country:US
Practice Address - Phone:484-818-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant