Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00056200 | NJ |
NPI | 1841554862 |
---|---|
Provider Name | Anke S Girolamo |
First Address | Howell, NJ 07731-2367 |
Second Address | Oceanport, NJ 07757-1162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 25/06/2012 |