Individual
MS. CHARLOTTE HEAVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
50 E NORTH ST, BUFFALO, NY 14203-1002
(716) 885-8318
Mailing address
50 E NORTH ST, BUFFALO, NY 14203-1002
(716) 885-8318
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024048-01
NY
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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