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Individual

AMY VIRGINIA MIKELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
41 OCONNOR RD, FAIRPORT, NY 14450-1327
(585) 383-2216
Mailing address
41 OCONNOR RD, FAIRPORT, NY 14450-1327
(585) 383-2216

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
011791-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30-0213081
TAX ID
NY
Enumeration date
10/03/2006
Last updated
09/25/2018
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