Individual
BERTHA COLLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1199 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-1424
(973) 414-4751
Mailing address
9 EDGEWOOD AVE N, WEST ORANGE, NJ 07052-3119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00601200
NJ
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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