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General NPI Number Information
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NPI Number | 1245674688
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Entity Type | Individual
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Provider Name | JODIE DASHORE OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/27/2013
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Last Update Date | 04/27/2013
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Provider Practice Location Address
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Address Line | 11 BURLINGTON DR
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City | MARLBORO
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State | NJ
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Zip | 07746-2609
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Country | US
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Telephone | 732-772-1989
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Fax | 732-333-4526
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Provider Business Mailing Address
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Address Line | 11 BURLINGTON DR
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City | MARLBORO
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State | NJ
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Zip | 07746-2609
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Country | US
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Telephone | 732-772-1989
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Fax | 732-333-4526
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 46TR0019680
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License Number State | NJ
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