Individual
MARLY DONNA BRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
550 W 148TH ST, NEW YORK, NY 10031-4108
(212) 234-2268
Mailing address
RR 2 BOX 4071, HENRYVILLE, PA 18332-1712
(570) 629-5075
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003226-1
NY
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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