Individual
MARIAM IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
525 AVENUE C, BAYONNE, NJ 07002-3750
(201) 484-9958
Mailing address
525 AVENUE C, BAYONNE, NJ 07002-3750
(201) 484-9958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008969
NY
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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