Individual
BETHANY MODICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
374 NORTH AVE, NORTH TONAWANDA, NY 14120-1722
(716) 909-7087
Mailing address
374 NORTH AVE, NORTH TONAWANDA, NY 14120-1722
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
020845
NY
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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