Individual
LISA BASLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
89 PIERMONT AVE, NYACK, NY 10960-4504
(845) 216-2416
Mailing address
89 PIERMONT AVE, NYACK, NY 10960-4504
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009025
NY
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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