Individual
DINA WIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
35 EMPIRE LN BSMT, LAKEWOOD, NJ 08701-5163
(732) 998-3145
Mailing address
35 EMPIRE LN BSMT, LAKEWOOD, NJ 08701-5163
(732) 998-3145
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
020468-1
NY
225X00000X
Occupational Therapist
Primary
46TR00733600
NJ
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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