Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003300328 |
---|---|
Provider Name | Melissa Olaya |
First Address | Vineland, NJ 08360-5306 |
Second Address | Mullica Hill, NJ 08062-2669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2018 |
Last Update Date | 05/03/2020 |