Individual
MISS JESSICA KARYN LISTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
25 FAWN DR, LIVINGSTON, NJ 07039-1905
(201) 704-0468
Mailing address
25 FAWN DR, LIVINGSTON, NJ 07039-1905
(201) 704-0468
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
020407
NY
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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