Individual
LISA MARIE COUSINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
119 BROCKLEY RD, ROCHESTER, NY 14609-5731
(585) 256-1950
Mailing address
41 OCONNOR RD, FAIRPORT, NY 14450-1327
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
011561-1
NY
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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