Individual
KESJANA DIVJAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CDT, MLD-C
Contact information
Practice address
269 US HIGHWAY 46 STE 128, LITTLE FERRY, NJ 07643-1438
(551) 352-8695
Mailing address
278 MAIN ST APT C2, LITTLE FERRY, NJ 07643-1375
(551) 352-8695
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01388300
NJ
Other
Enumeration date
01/10/2023
Last updated
01/11/2023
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