Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00620800 | NJ |
NPI | 1003414467 |
---|---|
Provider Name | Maggie W Mesce |
First Address | Wayne, NJ 07470-4308 |
Second Address | Wayne, NJ 07470-4308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2020 |
Last Update Date | 16/10/2020 |