Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00406300 | NJ |
NPI | 1568756401 |
---|---|
Provider Name | Mildred Lumapas |
First Address | Edison, NJ 08817-2841 |
Second Address | Edison, NJ 08817-2841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 05/12/2011 |