Individual
KATIE NICOLE BUCCELLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
128 PARK ROW STE 101, CADYVILLE, NY 12918-2817
(518) 561-6361
Mailing address
602 ASHLEY RD, WEST CHAZY, NY 12992-2606
(518) 578-7059
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
459406
NY
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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