Individual
CARLY SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
293 ROSE LN, SMITHTOWN, NY 11787-4417
(516) 983-5645
Mailing address
293 ROSE LN, SMITHTOWN, NY 11787-4417
(516) 983-5645
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
022980
NY
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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