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Individual

ELLEN WEYBRIGHT BEALS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
626 WATERVLIET SHAKER RD, SUITE 71, LATHAM, NY 12110-3618
(518) 877-4970
(866) 415-1258
Mailing address
PO BOX 11471, ALBANY, NY 12211-0471
(518) 877-4970
(866) 415-1258

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007564
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007564
NYS LICENSE NUMBER
NY
05
02871630
NY
Enumeration date
05/01/2007
Last updated
01/15/2008
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