Provider Demographics
NPI:1215298120
Name:RICHARD, MARY KLEIN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KLEIN
Last Name:RICHARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:32 DUNMOOR CT N
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3330
Mailing Address - Country:US
Mailing Address - Phone:609-890-4180
Mailing Address - Fax:
Practice Address - Street 1:1660 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3506
Practice Address - Country:US
Practice Address - Phone:609-586-4800
Practice Address - Fax:609-587-4500
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00092700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist