Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0119007383 | VA |
NPI | 1790207256 |
---|---|
Provider Name | Ms. Lauren Vesper |
First Address | Warren, NJ 07059-6702 |
Second Address | Warren, NJ 07059-6702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2017 |
Last Update Date | 16/07/2017 |