Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00002000 | NJ |
NPI | 1013563766 |
---|---|
Provider Name | Nancy Simon |
First Address | Hamilton, NJ 08619-2067 |
Second Address | Lawrenceville, NJ 08648-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2019 |
Last Update Date | 16/08/2019 |