Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XM0800X | Mental Health | 46TR00700200 | NJ |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00700200 | NJ |
NPI | 1659726073 |
---|---|
Provider Name | Mrs. Estee Saks |
First Address | Lakewood, NJ 08701 |
Second Address | Lakewood, NJ 08701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2016 |
Last Update Date | 08/05/2016 |