Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 46TR00440900 | NJ |
NPI | 1184764557 |
---|---|
Provider Name | Mrs. Jessica Abraham |
First Address | Whiting, NJ 08759-2912 |
Second Address | Whiting, NJ 08759-2912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 23/08/2011 |