| NPI | 1215392691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAM NELSON Manager 973-218-6394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: NJ 46TR00292210) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NJ QA009795) |
| 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00609200) | |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |