Individual
JACKELINE QUIROZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 DEAN DR # 1N, TENAFLY, NJ 07670-2764
(201) 503-7173
Mailing address
19 LEONARD TER, WAYNE, NJ 07470-3337
(973) 870-2119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01083700
NJ
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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