Provider Demographics
NPI:1942846076
Name:BOLTON, JASMINE MONIQUE (OTR)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MONIQUE
Last Name:BOLTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 STATE ROUTE 31 STE 1202
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-3389
Mailing Address - Country:US
Mailing Address - Phone:888-806-2497
Mailing Address - Fax:
Practice Address - Street 1:361 STATE ROUTE 31 STE 1202
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-3389
Practice Address - Country:US
Practice Address - Phone:888-806-2497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist