Individual
MISS INDIA LEAH FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
4555 BRONX BLVD, BRONX, NY 10470-1409
(347) 880-4443
(267) 306-4417
Mailing address
4555 BRONX BLVD, BRONX, NY 10470-1409
(347) 880-4443
(267) 306-4417
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007536
NY
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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