Individual
MS. KRISTEN R WHITLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
15813 72ND AVE, FRESH MEADOWS, NY 11365-1140
(718) 380-7600
Mailing address
3412 209TH ST, BAYSIDE, NY 11361-1406
(646) 675-4791
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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