Organization
OCCUPATIONAL PEDIATRIC THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALYN WICKLINE O.T.M.S. (OCCUPATIONAL THERAPIST)
(860) 417-8158
Entity
Organization
Contact information
Practice address
600 GREGORY AVE, WEEHAWKEN, NJ 07086-5814
(860) 417-8158
Mailing address
209 TEANECK ROAD, BARNEGAT, NJ 08005-2150
(860) 417-8158
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00625700
NJ
Other
Enumeration date
04/10/2016
Last updated
04/29/2016
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