Individual
EDUARDO JOSE VIQUEZ MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
155 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-2906
(973) 731-5100
Mailing address
1155 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-1424
(973) 731-5100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09226400
NJ
Other
Enumeration date
04/28/2022
Last updated
06/18/2022
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