Individual
JENNIFER HALLISSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
24 NESAQUAKE AVE, PORT WASHINGTON, NY 11050-2030
(516) 767-3879
Mailing address
24 NESAQUAKE AVE, PORT WASHINGTON, NY 11050-2030
(516) 767-3879
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
008540
NY
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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