Provider Demographics
NPI:1154800043
Name:VISNOV, JANET L (OTL)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:VISNOV
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:SCHICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2235 LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5885
Mailing Address - Country:US
Mailing Address - Phone:610-222-0222
Mailing Address - Fax:
Practice Address - Street 1:2235 LOCUST DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5885
Practice Address - Country:US
Practice Address - Phone:610-222-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-001718225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist