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General NPI Number Information
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NPI Number | 1720261050
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Entity Type | Individual
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Provider Name | JESSICA QUELLER KATZ LMT
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Gender | Female
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 68 1ST AVE STE L
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-1288
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Country | US
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Telephone | 732-539-8141
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Fax |
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Provider Business Mailing Address
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Address Line | 54 SOUTH AVE
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-1033
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Country | US
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Telephone | 732-539-8141
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 26BT00070500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT00292700
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License Number State | NJ
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