Individual
MRS. TRACY HELEN VANDEVORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
318 EAST 116TH STREET, ABC KEITH HARING SCHOOL, NEW YORK, NY 10029
(212) 426-3960
(212) 426-3961
Mailing address
125 GREENE STREET, APT 2, NEW YORK, NY 10012
(248) 505-0069
(847) 723-4353
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
019713
NY
225XP0200X
Pediatric Occupational Therapist
056008265
IL
Other
Enumeration date
03/10/2008
Last updated
10/12/2017
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