Provider Demographics
NPI:1740155605
Name:HENDRICKSON, ISABEL (OTD)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 KAREN PL
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-1027
Mailing Address - Country:US
Mailing Address - Phone:908-914-7731
Mailing Address - Fax:
Practice Address - Street 1:67A MOUNTAIN BLVD EXT STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5626
Practice Address - Country:US
Practice Address - Phone:908-873-6337
Practice Address - Fax:908-332-5668
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01253400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist