Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00204400 | NJ |
NPI | 1013276401 |
---|---|
Provider Name | Ms. Anne Marie Owens |
First Address | Lakewood, NJ 08701-4738 |
Second Address | Lakewood, NJ 08701-4738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2012 |
Last Update Date | 07/05/2012 |