Provider Demographics
NPI:1316503881
Name:NIENABER, JOAN M (OTR/L)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:NIENABER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:PFEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7305
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-0305
Mailing Address - Country:US
Mailing Address - Phone:970-593-8769
Mailing Address - Fax:
Practice Address - Street 1:99 CHERRY HILL RD STE 302
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1102
Practice Address - Country:US
Practice Address - Phone:973-909-5159
Practice Address - Fax:973-909-5112
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0002363225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist