Organization
MY FUNCTIONAL LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M SPALDO (OWNER)
(862) 432-5207
Entity
Organization
Contact information
Practice address
11 BREWSTER PL, FLANDERS, NJ 07836-9555
(862) 432-5207
Mailing address
11 BREWSTER PL, FLANDERS, NJ 07836-9555
(862) 432-5207
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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