Provider Demographics
NPI:1871970293
Name:LATEMPA, MICHELE (OTR)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:LATEMPA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JOCELYN PL
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1276
Mailing Address - Country:US
Mailing Address - Phone:862-377-9020
Mailing Address - Fax:
Practice Address - Street 1:123 N UNION AVE
Practice Address - Street 2:SUITE 204A
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2173
Practice Address - Country:US
Practice Address - Phone:908-233-3525
Practice Address - Fax:908-233-2267
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00697200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist