Individual
CHANEL T. DELISSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
370 MARCY AVE, BROOKLYN, NY 11206-4814
(718) 388-4800
Mailing address
330 LENOX RD APT 4M, BROOKLYN, NY 11226-2259
(917) 635-4610
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021433
NY
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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