Individual
CAITLIN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126
(315) 342-9575
(315) 342-7664
Mailing address
149 HICKORY HOLLOW DR, PALENVILLE, NY 12463-2619
(518) 965-2473
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
63021264
NY
225X00000X
Occupational Therapist
021264-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05202997
—
NY
Enumeration date
02/22/2017
Last updated
01/22/2020
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