Individual
MRS. LIANE MARIE GREEN-EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
183 WEBSTER ST, MALONE, NY 12953-2226
(518) 483-7802
Mailing address
115 COUNTY ROUTE 59, POTSDAM, NY 13676-3439
(315) 212-4971
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005842
NY
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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