Individual
MILISENTH REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13-03 COLUMBIA ST, FAIR LAWN, NJ 07410-2054
(201) 218-3571
Mailing address
13-03 COLUMBIA ST, FAIR LAWN, NJ 07410-2054
(201) 218-3571
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010666
NY
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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