Doctor Name: | MS. JOAN REVAK |
NPI Number: | 1154507341 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, OTR/L, CHT |
License Number: | 46TR00028700 |
Business Practice Address: | 220 Haddonfield Rd Cherry Hill, NJ - 080024403 |
Business Phone Number: | 8569107502 |
Business Fax Number: | 8569107505 |
Mailing Address: | 120 Buttonwood Ln, CINNAMINSON |
State: | NJ |
Postal Code: | 080772405 |
Phone Number: | 8567862214 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2008 |
NPI Last Update Date: | 01/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 46TR00028700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |