Individual
DANIELLE L KISTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 WEST AVE, BROCKPORT, NY 14420-1306
(585) 637-3140
Mailing address
663 SHARON DR, ROCHESTER, NY 14626-1952
(585) 305-5741
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024109
NY
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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