Individual
MARIE GEMIMA PONCE IGOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
42 INDIGO RD, HACKETTSTOWN, NJ 07840-4540
(551) 358-0586
Mailing address
42 INDIGO RD, HACKETTSTOWN, NJ 07840-4540
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TR00358500
NJ
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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