Provider Demographics
NPI:1588983274
Name:SCHUCKERS, JESSICA M (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:SCHUCKERS
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 1:90 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-1038
Mailing Address - Country:US
Mailing Address - Phone:814-265-7733
Mailing Address - Fax:814-265-7743
Practice Address - Street 1:90 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-1038
Practice Address - Country:US
Practice Address - Phone:814-265-7733
Practice Address - Fax:814-265-7743
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011153225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist