Individual
DIANE LYNN BARRICELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
500 PECONIC ST, APT 1-7B, RONKONKOMA, NY 11779-7100
(631) 846-7555
Mailing address
430 SILLS RD, YAPHANK, NY 11980
(631) 924-5583
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006916
NY
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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