Individual
MRS. DIANE VITILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9 TALCOTT CT, KENDALL PARK, NJ 08824-7013
(732) 960-1655
Mailing address
9 TALCOTT CT, KENDALL PARK, NJ 08824-7013
(732) 960-1655
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00508800
NJ
225XG0600X
Gerontology Occupational Therapist
Primary
46TR00508800
NJ
Other
Enumeration date
04/24/2010
Last updated
06/07/2010
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