Individual
KATHLEEN SIOBHAN EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
622 EAGLE ROCK AVE STE 108, WEST ORANGE, NJ 07052-2994
(973) 669-0072
Mailing address
3 BUTLER LN, WEST MILFORD, NJ 07480-1307
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00559400
NJ
Other
Enumeration date
12/31/2012
Last updated
01/10/2023
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