Individual
MISS ELIZABETH MAUREEN JENNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91 KELLAR RD, CENTRAL SQUARE, NY 13036-3113
(315) 345-9321
Mailing address
91 KELLAR RD, CENTRAL SQUARE, NY 13036-3113
(315) 345-9321
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
NY
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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