Individual
ASHLEY TERESA BREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4960 GLENWOOD DR, WILLIAMSVILLE, NY 14221-4111
(716) 392-4388
Mailing address
4960 GLENWOOD DR, WILLIAMSVILLE, NY 14221-4111
(716) 392-4388
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010280
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010280
—
NY
Enumeration date
11/07/2019
Last updated
11/07/2019
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