Individual
KEERA SIEDLECKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 CHERYL LN, EAST PATCHOGUE, NY 11772-4209
(631) 654-8753
Mailing address
9 CHERYL LN, EAST PATCHOGUE, NY 11772-4209
(631) 654-8753
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008715-1
NY
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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