Individual
PATRICE MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
115 FAIRVIEW AVE APT 52, JERSEY CITY, NJ 07304-5105
(551) 208-1182
Mailing address
115 FAIRVIEW AVE APT 52, JERSEY CITY, NJ 07304-5105
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00659500
NJ
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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