Provider Demographics
NPI:1073207296
Name:DIESSNER, DENISE ANNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANNE
Last Name:DIESSNER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 TAYLOR CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2354
Mailing Address - Country:US
Mailing Address - Phone:973-865-1127
Mailing Address - Fax:
Practice Address - Street 1:182 ADELAIDE ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2302
Practice Address - Country:US
Practice Address - Phone:201-390-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01050500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist