Individual
COREY LEQUEUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 HUGO AVE, WOODLAND PARK, NJ 07424-3302
(973) 934-1099
Mailing address
19 HUGO AVE, WOODLAND PARK, NJ 07424-3302
(973) 934-1099
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09238600
NJ
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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