Individual
JASON KEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
606 OLD ROUTE 17, MONTICELLO, NY 12701-7013
(845) 665-6795
Mailing address
138 CHAMPLIN AVE, LIBERTY, NY 12754-1617
(845) 665-6795
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007094
NY
224Z00000X
Occupational Therapy Assistant
OP006416
PA
Other
Enumeration date
05/14/2007
Last updated
08/11/2010
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