Provider Demographics
NPI:1417461146
Name:VANDEVEEGAETE, DAWN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:VANDEVEEGAETE
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 1:1054 HARMONY STATION RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-9579
Mailing Address - Country:US
Mailing Address - Phone:908-627-5975
Mailing Address - Fax:
Practice Address - Street 1:843 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-3453
Practice Address - Country:US
Practice Address - Phone:908-454-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00754400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist