Individual
MRS. ILAINE WISSING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OT/L
Contact information
Practice address
377 WESTCHESTER AVE, APT. 5H, PORT CHESTER, NY 10573-3603
(914) 934-9265
Mailing address
377 WESTCHESTER AVE, APT. 5H, PORT CHESTER, NY 10573-3603
(914) 934-9265
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005030
NY
Other
Enumeration date
10/18/2008
Last updated
10/18/2008
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