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Individual

MS. LAUREN JANE BODKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S OTR

Contact information

Practice address
64 TUXEDO DR, WAYNE, NJ 07470-2740
(973) 460-7379
Mailing address
64 TUXEDO DR, WAYNE, NJ 07470-2740
(973) 460-7379

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
63 014511
NY

Other

Enumeration date
10/30/2008
Last updated
10/24/2011
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