Individual
ANNI PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 RIVER AVE, SUITE 245, LAKEWOOD, NJ 08701-4738
(732) 367-1888
Mailing address
141 LINCOLN AVE, FAIR HAVEN, NJ 07704-3050
(732) 371-5240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00065700
NJ
225X00000X
Occupational Therapist
OC010760
PA
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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