Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00834700 | NJ |
NPI | 1528651213 |
---|---|
Provider Name | Blaire Janney |
First Address | Mount Laurel, NJ 08054-3418 |
Second Address | Mount Laurel, NJ 08054-3418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2021 |
Last Update Date | 15/02/2021 |