Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 46TA09002800 | NJ |
NPI | 1013199462 |
---|---|
Provider Name | Tara Lichter |
First Address | East Brunswick, NJ 08816-1801 |
Second Address | East Brunswick, NJ 08816-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2007 |
Last Update Date | 28/11/2007 |