Individual
FAITH PROVOST HARDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
150 VAN BUREN ST, NEWARK, NY 14513-1238
(315) 331-7741
(315) 331-0566
Mailing address
5419 RUSSELL RD, MARION, NY 14505-9357
(315) 589-9236
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0017811
NY
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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