Individual
MRS. MANDY VANDERBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
65 N SUSSEX ST, DOVER, NJ 07801-3949
(973) 361-5200
Mailing address
53 PASSAIC AVE, OGDENSBURG, NJ 07439-1172
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00464200
NJ
Other
Enumeration date
09/24/2011
Last updated
09/24/2011
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