Individual
MS. MARY REBECCA FAIRBANKS RASOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
33 CENTRAL AVE, MIDLAND PARK, NJ 07432-1401
(201) 632-1900
Mailing address
150 PINEWOOD PL, TEANECK, NJ 07666-4921
(201) 681-8233
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09231000
NJ
Other
Enumeration date
02/09/2023
Last updated
06/22/2023
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