Doctor Name: | JESSICA VANNEST |
NPI Number: | 1679828156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTRL |
License Number: | 46TR00290300 |
Business Practice Address: | 500 Main St Building 2 Lanoka Harbor, NJ - 087342228 |
Business Phone Number: | 7325816758 |
Business Fax Number: | 7323580284 |
Mailing Address: | 117 Oak St, FORKED RIVER |
State: | NJ |
Postal Code: | 087314219 |
Phone Number: | 7325816758 |
Fax Number: | 7323580284 |
NPI Enumeration Date: | 07/19/2012 |
NPI Last Update Date: | 07/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 46TR00290300 |
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. |