Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00097000 | NJ |
NPI | 1043664949 |
---|---|
Provider Name | Michelle Critelli |
First Address | Medford, NJ 08055-3944 |
Second Address | Cherry Hill, NJ 08003-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2016 |
Last Update Date | 17/04/2016 |