Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00841800 | NJ |
NPI | 1023631777 |
---|---|
Provider Name | Victoria Seamon |
First Address | Somerset, NJ 08873-6474 |
Second Address | Edison, NJ 08817-2507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2020 |
Last Update Date | 28/05/2020 |