Individual
MANDALEE HARRIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21857 110TH AVE, QUEENS VILLAGE, NY 11429-2516
(917) 279-6819
Mailing address
21857 110 AVE, QUEENSVILLAGE, NY 11429
(917) 279-6819
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1016238
NY
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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