Individual
ETOSHA D WHITAKER-KABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
406 EASTGATE DR, MONMOUTH JUNCTION, NJ 08852-2614
(215) 220-5366
Mailing address
406 EASTGATE DR, MONMOUTH JUNCTION, NJ 08852-2614
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00531200
NJ
Other
Enumeration date
09/16/2010
Last updated
01/17/2012
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