Individual
ADELE MIMNAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
155 S WASHINGTON AVE, BERGENFIELD, NJ 07621-2933
(201) 374-1213
Mailing address
155 S WASHINGTON AVE, BERGENFIELD, NJ 07621-2933
(201) 374-1213
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00104000
NJ
Other
Enumeration date
04/08/2017
Last updated
04/08/2017
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