Individual
GAURI WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1 ELSIE ST, ROME, NY 13440-2556
(315) 339-2220
Mailing address
4 FAMILY CIR, LEE CENTER, NY 13363-9728
(315) 571-4229
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
012476-1
NY
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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