Provider Demographics
NPI:1912134891
Name:HOOGHUIS, MARY ANNE
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANNE
Last Name:HOOGHUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ANNE
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2 WOODBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2131
Mailing Address - Country:US
Mailing Address - Phone:908-217-0325
Mailing Address - Fax:
Practice Address - Street 1:2 WOODBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2131
Practice Address - Country:US
Practice Address - Phone:908-217-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002909-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics