Individual
ILEENE M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1129 BLOOMFIELD AVE, WEST CALDWELL, NJ 07006-7127
(973) 575-3321
(973) 575-1102
Mailing address
9 CATON TER, CALDWELL, NJ 07006-4808
(973) 226-6113
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09005600
NJ
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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