Individual
MRS. LESLIE OLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
3349 HWY 138, BLDG. B. SUTIE A., WALL TOWNSHIP, NJ 07719-9671
(732) 280-6050
(732) 280-6056
Mailing address
157 THOMPSON BRIDGE RD, JACKSON, NJ 08527-4624
(732) 987-5267
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00191500
NJ
Other
Enumeration date
07/18/2014
Last updated
07/28/2014
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