Individual
MARIA TANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
167 WALKER RD, WEST ORANGE, NJ 07052-3812
(347) 393-1071
Mailing address
167 WALKER RD, WEST ORANGE, NJ 07052-3812
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00559600
NJ
Other
Enumeration date
08/07/2016
Last updated
08/07/2016
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