Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR0019680 | NJ |
NPI | 1245674688 |
---|---|
Provider Name | Dr. Jodie Dashore |
First Address | Marlboro, NJ 07746-2609 |
Second Address | Marlboro, NJ 07746-2609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2013 |
Last Update Date | 27/04/2013 |