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Individual

MARYANN BOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAE, OTR

Contact information

Practice address
2621 STATE HIGHWAY 138 EAST, WALL, NJ 07719-9660
(732) 556-1060
Mailing address
5 MARC ALTON CT, JACKSON, NJ 08527-4338
(732) 370-0384

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00017000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46TR00017000
OT LICENSURE #
NJ
Enumeration date
03/27/2007
Last updated
07/08/2007
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