Individual
KALISTA CONCETTA JAVENES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
208 HARRISTOWN RD, GLEN ROCK, NJ 07452-3308
(201) 297-9167
Mailing address
2 RIDGETOP DR, TOMKINS COVE, NY 10986-1647
(845) 642-7571
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR01119300
NJ
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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