Individual
MRS. DIANNE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
160 LAWRENCE AVE, BROOKLYN, NY 11230-1103
(718) 450-5406
Mailing address
288 QUINCY ST, BROOKLYN, NY 11216-1408
(347) 365-5745
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
003895-1
NY
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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