Individual
MARIA JESUS LAGO-RIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
132 EVERGREEN RD, EDISON, NJ 08837-2484
(732) 452-4100
Mailing address
20 CHARLES ST, NUTLEY, NJ 07110-1033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09076200
NJ
Other
Enumeration date
12/03/2017
Last updated
12/03/2017
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