Individual
LAUREN GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-4323
(201) 848-4259
Mailing address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09097100
NJ
Other
Enumeration date
04/06/2014
Last updated
04/06/2014
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