Individual
MISS EMMA ROSE SHABALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 IRVING PL, NEW YORK, NY 10003-2305
(716) 866-0967
Mailing address
122 S CAYUGA RD, BUFFALO, NY 14221-6731
(716) 866-0967
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
462554
NY
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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