Individual
EVA DIANNE JEAN-GILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4275 65TH PL, WOODSIDE, NY 11377-5054
(718) 540-2142
Mailing address
18311 HILLSIDE AVE APT 9L, JAMAICA, NY 11432-4851
(917) 319-2624
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009354
NY
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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