Individual
COLLEEN ANN DERITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OTR/L, ACE CPT
Contact information
Practice address
159 SMITH CIR, POINT PLEASANT BORO, NJ 08742-5414
(732) 206-8189
Mailing address
159 SMITH CIR, POINT PLEASANT, NJ 08742-5856
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
005686
NY
225X00000X
Occupational Therapist
Primary
46TR00485500
NJ
Other
Enumeration date
07/05/2007
Last updated
05/13/2014
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