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Individual

MS. MARGO M VIVLAMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
99 ELM ST, ST JOSEPHS ELEMENTARY, MALONE, NY 12953-1519
(518) 483-7806
Mailing address
4 ISLAND ST PO BOX 95, NORFOLK, NY 13667
(518) 483-7806

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
64005130
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
64005130
NYS
NY
Enumeration date
10/04/2010
Last updated
10/04/2010
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