Individual
KIMBERLY FAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 W MAIN ST STE 2, FREEHOLD, NJ 07728-2523
(732) 431-3602
(732) 431-3603
Mailing address
900 W MAIN ST STE 2, FREEHOLD, NJ 07728-2523
(732) 431-3602
(732) 431-3603
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TR00126500
NJ
Other
Enumeration date
05/31/2017
Last updated
07/21/2022
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