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Individual
MRS. DIANE MODICA
Active
Individual
MRS. DIANE MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR CHT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00190911
NJ
225XH1200X
Hand Occupational Therapist
Primary
9209001871
NULL
Other
Enumeration date
12/04/2006
Last updated
09/11/2025
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