Individual
MISS LAURA L DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
123 HAINES NECK RD, SALEM, NJ 08079-4516
(856) 299-7779
Mailing address
123 HAINES NECK RD, SALEM, NJ 08079-4516
(856) 299-7779
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
46TA09043100
NJ
Other
Enumeration date
04/07/2007
Last updated
07/08/2007
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