Individual
ALEXIS DEJIANNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
125 LINDEN DR, FAIR HAVEN, NJ 07704-3536
(201) 320-8873
Mailing address
125 LINDEN DR, FAIR HAVEN, NJ 07704-3536
(201) 320-8873
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
46TR00334400
NJ
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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