Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 46TR0003300 | NJ |
NPI | 1003369745 |
---|---|
Provider Name | Jennifer Klesat |
First Address | Flemington, NJ 08822-1323 |
Second Address | Flemington, NJ 08822-4671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2016 |
Last Update Date | 29/07/2016 |