Individual
MRS. DAWN FASANO-HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1129 BLOOMFIELD AVE, WEST CALDWELL, NJ 07006-7127
(973) 575-7576
Mailing address
150 GASTON AVE, GARFIELD, NJ 07026-1208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA09053900
NJ
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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