Individual
BAILA WACHSSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2557 HOOPER AVE, BRICK, NJ 08723-6238
(732) 701-3711
(732) 701-3709
Mailing address
1112 SOMERSET AVE, LAKEWOOD, NJ 08701-2138
(732) 228-3505
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00303
—
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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