Individual
MARENA LEIGH TAVERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1601 ARMORY DR, UTICA, NY 13501-5405
(315) 798-4006
Mailing address
245 OXFORD RD APT 28C, NEW HARTFORD, NY 13413-4328
(315) 794-6759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
027190
NY
225XP0200X
Pediatric Occupational Therapist
Primary
027190
NY
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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