Individual
ALYSSA ANNE PROULX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
173 PERFIELD RD, HASTINGS, NY 13076-3127
(518) 925-1930
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010201
NY
Other
Enumeration date
08/11/2019
Last updated
08/11/2019
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