Individual
MRS. SHANA MARIE GJELSVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 LINDEN AVE, STANHOPE, NJ 07874
(973) 347-5519
Mailing address
33 RIDGE RD, SUCCASUNNA, NJ 07876-1841
(973) 886-0606
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00279800
NJ
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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