Individual
MARY ELIZABETH MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
70 5TH ST, GLENS FALLS, NY 12801-4139
(518) 636-9755
Mailing address
70 5TH ST, GLENS FALLS, NY 12801-4139
(518) 636-9755
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
P78805
NY
Other
Enumeration date
01/12/2011
Last updated
07/24/2012
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