Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 46TR00305500 | NJ |
NPI | 1003011156 |
---|---|
Provider Name | Mahalia Elaine S Ong |
First Address | Clark, NJ 07066-1014 |
Second Address | Westfield, NJ 07090-1419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 03/02/2021 |