Provider Demographics
NPI:1093457962
Name:HARKINS, JACQUELINE (OTR/L, MS, CNS)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:HARKINS
Suffix:
Gender:F
Credentials:OTR/L, MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:99 KINDERKAMACK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3012
Mailing Address - Country:US
Mailing Address - Phone:845-380-3486
Mailing Address - Fax:
Practice Address - Street 1:99 KINDERKAMACK RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3012
Practice Address - Country:US
Practice Address - Phone:845-380-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00751100225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation