Healthcare Provider Details

I. General information

NPI: 1164346417
Provider Name (Legal Business Name): ELIZABETH ANN DANOVICH MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 APPLETREE LN
SEWELL NJ
08080-3022
US

IV. Provider business mailing address

22 APPLETREE LN
SEWELL NJ
08080-3022
US

V. Phone/Fax

Practice location:
  • Phone: 856-812-1696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01141900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: