Individual
MRS. DESIREE KOPIL GANNON
Active
Individual
MRS. DESIREE KOPIL GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
008498-1
NY
225XP0200X
Pediatric Occupational Therapist
46TR00098800
NJ
Other
Enumeration date
02/26/2009
Last updated
03/28/2012
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