Individual
SOPHIA DASTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87-89 S RTE 9W, HAVERSTRAW, NY 10927
(845) 429-5381
Mailing address
30 S DOUGHTY AVE APT 407, SOMERVILLE, NJ 08876-2833
(845) 300-0513
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09106700
NJ
Other
Enumeration date
03/04/2015
Last updated
03/09/2015
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