Provider Demographics
NPI:1740761113
Name:KANIA, JEANNE W (OT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:W
Last Name:KANIA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MARGUERITE LN
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-4124
Mailing Address - Country:US
Mailing Address - Phone:908-472-8003
Mailing Address - Fax:
Practice Address - Street 1:1001 CENTER ST
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-1347
Practice Address - Country:US
Practice Address - Phone:609-296-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00005300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist