Basic Information
| Provider Information | |||||||||
| NPI: | 1144274283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ST-PIERRE | ||||||||
| FirstName: | LUCILLE | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 S CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193823202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104317014 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4709 KIRKWOOD HWY | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198085007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029989880 | ||||||||
| FaxNumber: | 3029987498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | J2-0000220 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.