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Individual

MRS. BROOKE R NIKITICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3 INDUSTRIAL WAY E, EATONTOWN, NJ 07724-3318
(732) 544-1557
Mailing address
303 E ELM AVE, GALLOWAY, NJ 08205-9713
(518) 944-1670

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09150500
NJ

Other

Enumeration date
03/09/2023
Last updated
03/09/2023
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