Individual
JENNIFER BOTTALICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9 MARYLAND AVE, HAINESPORT, NJ 08036-3513
(800) 950-6066
Mailing address
9 MARYLAND AVE, HAINESPORT, NJ 08036-3513
(800) 950-6066
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09071600
NJ
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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