Individual
MS. MARY HELEN MICINOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
49 BIRCHWOOD DR, PINE BUSH, NY 12566-3900
(845) 313-6407
Mailing address
49 BIRCHWOOD DR, PINE BUSH, NY 12566-3900
(845) 313-6407
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002951-1
NY
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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