Individual
MISS DANIELLE ST. VICTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
19165 115RD, SAINT ALBANS, NY 11412
(718) 528-2003
Mailing address
19165 115TH RD, SAINT ALBANS, NY 11412-2707
(718) 528-2003
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
014076
NY
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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