Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00658500 | NJ |
NPI | 1396139606 |
---|---|
Provider Name | Deborah Diangelo |
First Address | Cherry Hill, NJ 08003-2334 |
Second Address | Cherry Hill, NJ 08003-2334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 25/03/2015 |