Individual
MISS JOHANNA HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
2174 AMSTERDAM AVE APT 41, NEW YORK, NY 10032-2464
(212) 781-3727
Mailing address
2174 AMSTERDAM AVE APT 41, NEW YORK, NY 10032-2464
(212) 781-3727
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007305
NY
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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