Individual
CAROL MARIE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 CONSELYEA ST, BROOKLYN, NY 11211-2516
(718) 782-1462
Mailing address
611 W 177TH ST APT 53, NEW YORK, NY 10033-7119
(347) 327-2525
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
027550
NY
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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