Individual
KRISTINA MARIE WIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 WARREN PL, ITHACA, NY 14850-3147
(607) 351-9778
Mailing address
630 WARREN PL, ITHACA, NY 14850-3147
(607) 351-9778
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005487-1
NY
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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