Individual
RENEE L BOLDUC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
199 BERGEN TPKE APT 3L, RIDGEFIELD PARK, NJ 07660-2342
(201) 641-4832
Mailing address
199 BERGEN TPKE APT 3L, RIDGEFIELD PARK, NJ 07660-2342
(201) 641-4832
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
007426-1
NY
224Z00000X
Occupational Therapy Assistant
Primary
46TA09075800
NJ
Other
Enumeration date
07/16/2007
Last updated
04/25/2015
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