Individual
EDIT MULLAKANDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
10101 67TH DR APT 3B, FOREST HILLS, NY 11375-2701
(347) 232-1776
Mailing address
10101 67TH DR APT 3B, FOREST HILLS, NY 11375-2701
(347) 232-1776
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
023266
NY
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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