Individual
MS. KILEY NOELLE MACKOWIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
28398
NY
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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