Individual
MS. MARYGRACE ALICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
59 GREYWOOD DR, ORANGEBURG, NY 10962-2428
(845) 398-3937
Mailing address
59 GREYWOOD DR, ORANGEBURG, NY 10962-2428
(845) 398-3937
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009767-1
NY
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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