Individual
DIANA SLAVYANA PONIZHAYLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 PEARL AVE, JOHNSON CITY, NY 13790-1514
(607) 321-3272
Mailing address
18 PEARL AVE, JOHNSON CITY, NY 13790-1514
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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