Individual
EMILY WISHNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 AMERICA AVE UNIT 108, LAKEWOOD, NJ 08701-4581
(914) 629-8199
Mailing address
15 AMERICA AVE UNIT 108, LAKEWOOD, NJ 08701-4581
(914) 629-8199
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OC014022
PA
252Y00000X
Early Intervention Provider Agency
OC014022
PA
Other
Enumeration date
09/23/2021
Last updated
10/07/2021
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