Provider Demographics
NPI:1407506264
Name:KATHERINE VAN NESS, MS, OTL LLC
Entity Type:Organization
Organization Name:KATHERINE VAN NESS, MS, OTL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN NESS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OT/L
Authorized Official - Phone:973-219-2031
Mailing Address - Street 1:3 STARLIGHT RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-9778
Mailing Address - Country:US
Mailing Address - Phone:973-219-2031
Mailing Address - Fax:
Practice Address - Street 1:3 STARLIGHT RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07438-9778
Practice Address - Country:US
Practice Address - Phone:973-219-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty