Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health | 46TR00045400 | NJ |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00045400 | NJ |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00045400 | NJ |
NPI | 1750757548 |
---|---|
Provider Name | Heide Rosenkranz Ratliff |
First Address | Princeton, NJ 08540-2903 |
Second Address | Princeton, NJ 08540-2903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2015 |
Last Update Date | 14/08/2015 |