Individual
MRS. CHRISTINE DERTOUZOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
500 RIVER AVE, LAKEWOOD, NJ 08701-4738
(732) 367-1888
Mailing address
410 SUTHERLAND RD, EWING, NJ 08618-2415
(609) 977-8189
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TR001316
NJ
Other
Enumeration date
12/25/2011
Last updated
12/25/2011
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