Individual
ANGELIQUE GILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3911 AVENUE P, BROOKLYN, NY 11234-3501
(718) 377-5000
(718) 377-5002
Mailing address
4627 206TH ST, BAYSIDE, NY 11361-3162
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5941
NY
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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