Individual
MISS JILL M HALSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2495 MAIN ST, SUITE 234, BUFFALO, NY 14214-2152
(716) 836-5929
Mailing address
10546 HARPER RD APT B, DARIEN CENTER, NY 14040-9719
(585) 813-7016
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005567-1
NY
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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