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General NPI Number Information
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NPI Number | 1750968426
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Entity Type | Individual
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Provider Name | MARCELLE EMILY WALKER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 220 LIVINGSTON ST STE 112
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City | NORTHVALE
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State | NJ
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Zip | 07647-1739
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Country | US
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Telephone | 201-564-7515
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Fax |
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Provider Business Mailing Address
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Address Line | 30 GRENADA PL
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4304
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Country | US
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Telephone | 973-699-3474
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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 | 46TR00973100
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License Number State | NJ
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