Individual
COURTNEY A CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
64 LOCUST DR, MASTIC BEACH, NY 11951-5512
(631) 772-2721
Mailing address
64 LOCUST DR, MASTIC BEACH, NY 11951-5512
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0112911
NY
Other
Enumeration date
01/13/2007
Last updated
07/08/2007
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