Individual
MISS ELBALIZ MENDEZ VALENTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1528 EDGEMERE RD, WALL TOWNSHIP, NJ 07719-3909
(201) 874-7627
Mailing address
PO BOX 354, BELMAR, NJ 07719-0354
(201) 874-7627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09125800
NJ
Other
Enumeration date
02/12/2017
Last updated
11/26/2018
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