Provider Demographics
NPI:1043564487
Name:OCCUPATIONAL THERAPY CONSULTANTS, INC
Entity Type:Organization
Organization Name:OCCUPATIONAL THERAPY CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:LISBONA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:732-764-0202
Mailing Address - Street 1:1661 ROUTE 22 WEST
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1258
Mailing Address - Country:US
Mailing Address - Phone:732-764-0202
Mailing Address - Fax:732-764-0030
Practice Address - Street 1:1661 ROUTE 22 WEST
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1258
Practice Address - Country:US
Practice Address - Phone:732-764-0202
Practice Address - Fax:732-764-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health