Individual
CARREL GONZALES SESE LAVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1070 CLIFTON AVE, CLIFTON, NJ 07013-3619
(973) 246-6565
Mailing address
575 GROVE ST UNIT E6, CLIFTON, NJ 07013-3177
(201) 889-3902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0138401-1
NY
225X00000X
Occupational Therapist
46TR00429200
NJ
Other
Enumeration date
07/26/2010
Last updated
11/02/2012
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