Individual
MRS. RAQUEL MARIA LOGAN-BASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
415 BEVERLEY RD, APT. UNIT LT, BROOKLYN, NY 11218-3153
(718) 972-6561
Mailing address
20 WENDELL ST, APT. #6F, HEMPSTEAD, NY 11550-1206
(516) 385-1886
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004893-1
NY
Other
Enumeration date
08/28/2010
Last updated
08/28/2010
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