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Individual

MS. DENISE NICOLE BREAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTA

Contact information

Practice address
38 PROSPECT AVE, CATSKILL, NY 12414-1514
(518) 943-5701
Mailing address
3202 ROUTE 145 # 2, PRESTON HOLLOW, NY 12469-1806
(518) 390-0045

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007951-01
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007951-01
NY
Enumeration date
10/17/2021
Last updated
10/17/2021
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