Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00291000 | NJ |
NPI | 1073077350 |
---|---|
Provider Name | Mrs. Stephanie Valdeon |
First Address | Little Silver, NJ 07739-1406 |
Second Address | Little Silver, NJ 07739-1406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2019 |
Last Update Date | 30/01/2019 |