Individual
MRS. ALICIA ESTHER PUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
572 EVERGREEN DR, TALLMADGE, OH 44278-1359
(631) 758-0089
Mailing address
572 EVERGREEN DR, TALLMADGE, OH 44278-1359
(631) 758-0089
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007164
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UP243425
STATE DRIVER'S LICENSE
OH
Enumeration date
02/08/2007
Last updated
01/04/2021
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