Individual
JENINE GAUQUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
64 GROVE ST, BEACON, NY 12508-3445
(845) 831-8114
Mailing address
64 GROVE ST, BEACON, NY 12508-3445
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006671
NY
Other
Enumeration date
05/22/2007
Last updated
06/26/2008
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