Individual
TRISTA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
130 LOMOND CT, UTICA, NY 13502-5951
(315) 724-4286
Mailing address
9847 HAWKINSVILLE RD, BOONVILLE, NY 13309-5519
(315) 794-5377
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7968446
NY
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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