Individual
MRS. ELLEN I TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
57 MUNGER ST, BERGEN, NY 14416-9573
(585) 330-2135
Mailing address
57 MUNGER ST, PO BOX 6, BERGEN, NY 14416-9573
(585) 330-2135
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003803-1
NY
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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