Individual
KEYANA PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
92 BURNETT AVE APT 216, MAPLEWOOD, NJ 07040-2983
(908) 414-8473
Mailing address
92 BURNETT AVE APT 216, MAPLEWOOD, NJ 07040-2983
(908) 414-8473
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
008730
NY
225XP0200X
Pediatric Occupational Therapist
Primary
028554
NY
Other
Enumeration date
08/12/2015
Last updated
01/17/2024
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