Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00898200 | NJ |
NPI | 1336761600 |
---|---|
Provider Name | Ms. Jenna J Baratta |
First Address | Manalapan, NJ 07726 |
Second Address | Manalapan, NJ 07726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2020 |
Last Update Date | 04/06/2020 |