Provider Demographics
NPI:1295370690
Name:STANDEN, ALLISON (OTR)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:STANDEN
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 1:49 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1273
Mailing Address - Country:US
Mailing Address - Phone:609-468-8163
Mailing Address - Fax:
Practice Address - Street 1:49 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-1273
Practice Address - Country:US
Practice Address - Phone:609-468-8163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00778100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist