Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 004665 | NY |
NPI | 1265063812 |
---|---|
Provider Name | Ms. Dawn Marie Nilsen |
First Address | Little Egg Harbor Twp, NJ 08087-1517 |
Second Address | Little Egg Harbor Twp, NJ 08087-1517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2020 |
Last Update Date | 03/02/2020 |