Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 46TA09053700 | NJ |
NPI | 1003144726 |
---|---|
Provider Name | Mrs. Melissa Ann O'brien |
First Address | Mount Holly, NJ 08060-1218 |
Second Address | Voorhees, NJ 08043-9547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2009 |
Last Update Date | 19/11/2009 |