Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00465600 | NJ |
NPI | 1932362209 |
---|---|
Provider Name | Mrs. Sima Wolf |
First Address | Oceanport, NJ 07757-1162 |
Second Address | Oceanport, NJ 07757-1162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 08/07/2008 |