Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 011299-1 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 46TR00205000 | NJ |
NPI | 1073726824 |
---|---|
Provider Name | Mrs. Alicia Marie Macgregor |
First Address | Cherry Hill, NJ 08003-1000 |
Second Address | Cherry Hill, NJ 08003-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 29/04/2013 |