Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 004455-1 | NY |
Y | 225XH1200X | Occupational Therapist - Hand | 46TR00007200 | NJ |
NPI | 1215151378 |
---|---|
Provider Name | Nancy K Becker |
First Address | Ridgewood, NJ 07450 |
Second Address | Ridgewood, NJ 07450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |