Individual
MRS. DANIELLE EVANS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
554 LARKFIELD RD, SUITE 207, EAST NORTHPORT, NY 11731-4205
(631) 266-4501
Mailing address
459 CLAY PITTS RD, EAST NORTHPORT, NY 11731-3821
(631) 486-2937
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
008829-1
NY
225XP0200X
Pediatric Occupational Therapist
008829
NY
Other
Enumeration date
01/29/2007
Last updated
12/16/2008
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