Individual
MRS. AMI MARIE GYDESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
22567 SUMMIT DR BLDG 2, WATERTOWN, NY 13601-7210
(315) 779-6784
Mailing address
22567 SUMMIT DR BLDG 2, WATERTOWN, NY 13601-7210
(315) 779-6784
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0058651
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04329911
—
NY
Enumeration date
09/15/2006
Last updated
04/23/2024
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