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NPI 1184609463

NPI 1184609463 : CATHY SUE CARTER O.T.R./L : WEST ORANGE, NJ

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General NPI Number Information
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    NPI Number           |    1184609463
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    Entity Type          |    Individual 
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    Provider Name        |    CATHY SUE CARTER O.T.R./L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/09/2005
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    Last Update Date     |    08/13/2008
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Provider Practice Location Address
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    Address Line         |    1199 PLEASANT VALLEY WAY 
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    City                 |    WEST ORANGE
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    State                |    NJ
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    Zip                  |    07052-1424
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    Country              |    US
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    Telephone            |    973-414-4729
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    Fax                  |    973-414-4709
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Provider Business Mailing Address
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    Address Line         |    44 MANGER RD 
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    City                 |    WEST ORANGE
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    State                |    NJ
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    Zip                  |    07052-1708
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    Country              |    US
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    Telephone            |    973-736-7121
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    2776
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    License Number State |    CA
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