Provider Demographics
NPI:1033536172
Name:CHALLENDER, ELIZABETH IRENE (MS, OT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:IRENE
Last Name:CHALLENDER
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 DEACON RD
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2641
Mailing Address - Country:US
Mailing Address - Phone:609-315-7146
Mailing Address - Fax:
Practice Address - Street 1:835 DEACON RD
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2641
Practice Address - Country:US
Practice Address - Phone:609-315-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00106500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist