Individual provider · NPI-1

Kisha Manley

Occupational Therapy Assistant · Newark, NJ

NPI number1528474285
StatusActive
Last updated in NPPESJul 2, 2014

Details

NPI
1528474285
Entity type
Individual (NPI-1)
Name
Kisha Manley
Sex
Female
Sole proprietor
No
Enumeration date
Jul 2, 2014
Last updated
Jul 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224Z00000X Occupational Therapy Assistant008107-1NYYes

Practice location

68 Summer Ave
Newark, NJ 07104-2512

Phone 862-216-4030

Mailing address

68 Summer Ave
Newark, NJ 07104-2512

Phone 862-216-4030

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