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General NPI Number Information
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NPI Number | 1174714901
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Entity Type | Individual
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Provider Name | COLLEEN L. MORGAN MAOTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 270 INDUSTRIAL WAY W
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City | EATONTOWN
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State | NJ
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Zip | 07724-2206
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Country | US
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Telephone | 732-542-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 97 COLUMBIA AVE
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City | LONG BRANCH
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State | NJ
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Zip | 07740-7914
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Country | US
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Telephone | 732-222-2028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | TR00265100
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License Number State | NJ
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