Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00485200 | NJ |
NPI | 1083083331 |
---|---|
Provider Name | Miss Courtney Lindsay |
First Address | Hoboken, NJ 07030-6017 |
Second Address | Hoboken, NJ 07030-6017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2015 |
Last Update Date | 16/09/2015 |