Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 46TA09011900 | NJ |
NPI | 1992994834 |
---|---|
Provider Name | Carolyn Kline |
First Address | Oceanport, NJ 07757-1184 |
Second Address | Oceanport, NJ 07757-1184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 16/10/2007 |