Individual
MISS DONNA NOEL LICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
206 LINDBERGH BLVD, TEANECK, NJ 07666-6524
(201) 281-8053
Mailing address
206 LINDBERGH BLVD, TEANECK, NJ 07666-6524
(201) 281-8053
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00453600
NJ
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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