Individual
KEITH NICKOLES HORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
43 NEW SCOTLAND AVE, ALBANY, NY 12208-3478
(518) 262-3125
Mailing address
43 NEW SCOTLAND AVE, ALBANY, NY 12208-3478
(518) 262-3125
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011616
NY
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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