Individual
ANDREA RAPHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4646 FAIRPORT NINE MILE PT RD, FAIRPORT, NY 14450-1163
(585) 377-0350
Mailing address
12 CHATEAU SQ, ROCHESTER, NY 14618-5131
(585) 813-5455
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
P10746
NY
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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