Individual
MRS. SUSAN MICHELE CLANCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14 REYNOLDS RD, SHOREHAM, NY 11786-1940
(631) 744-5651
Mailing address
14 REYNOLDS RD, SHOREHAM, NY 11786-1940
(631) 744-5651
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006054-1
NY
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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