Individual
MRS. MARLENE ANN FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2495 MAIN ST, 234, BUFFALO, NY 14214-2152
(716) 836-5929
Mailing address
12510 MIDDLE RD, SARDINIA, NY 14134-9703
(716) 496-5425
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000989-1
NY
Other
Enumeration date
01/14/2011
Last updated
01/14/2011
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