Individual
HADASSA PORTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1135 E VETERANS HWY STE 4, JACKSON, NJ 08527-5090
(732) 813-4263
Mailing address
11 SHAYAS RD BSMT, LAKEWOOD, NJ 08701-5564
(518) 542-0234
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09226700
NJ
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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