Individual
ALICIA OTOOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 ROUTE 36, LEONARDO, NJ 07737-1709
(908) 461-2831
(732) 355-6759
Mailing address
121 ANTONIA CT, LINCROFT, NJ 07738-1537
(908) 461-2831
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01034500
NJ
235Z00000X
Speech-Language Pathologist
46TR01034500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR01034500
STATE OF NJ
NJ
Enumeration date
04/01/2022
Last updated
06/08/2022
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