Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00249700 | NJ |
N | 225XH1200X | Occupational Therapist - Hand | 46TR00249700 | NJ |
NPI | 1154360600 |
---|---|
Provider Name | Karen M Hancheck |
First Address | Clark, NJ 07066-1014 |
Second Address | Toms River, NJ 08753-2895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 27/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P35711 | (02) | NJ |