Individual
TRACIE KEARNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 ALPS RD, WAYNE, NJ 07470-3704
(845) 742-4530
Mailing address
4305 RAMAPO CT, RIVERDALE, NJ 07457-1664
(845) 742-4530
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09010100
NJ
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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