Individual
MRS. TARA CERVANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
899 PINES LAKE DR W, WAYNE, NJ 07470-6107
(201) 744-5740
Mailing address
83 LACKAWANNA AVE APT 138, WALLINGTON, NJ 07057-2092
(845) 728-8407
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
46TA09088400
NJ
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
46TR00890300
NJ
Other
Enumeration date
06/29/2018
Last updated
09/05/2024
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