Provider Demographics
NPI:1205163136
Name:SKAWINSKI, JOANNE (COTA)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:SKAWINSKI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-18 ELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2907
Mailing Address - Country:US
Mailing Address - Phone:201-321-1092
Mailing Address - Fax:
Practice Address - Street 1:23-18 ELLINGTON RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2907
Practice Address - Country:US
Practice Address - Phone:201-321-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TAO9000600224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant