Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 46TR00233900 | NJ |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00233900 | NJ |
NPI | 1053574384 |
---|---|
Provider Name | Mrs. Jennifer L Kraeuter |
First Address | Princeton, NJ 08540-1512 |
Second Address | Princeton, NJ 08540-1512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 23/05/2021 |