Individual
IVY LOU MANUBAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 MILL ST UNIT H3, BELLEVILLE, NJ 07109-5306
(201) 535-8555
Mailing address
34 VERANDA AVE, LITTLE FALLS, NJ 07424-1074
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00456900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134350937
—
NJ
Enumeration date
07/29/2009
Last updated
08/11/2022
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