Individual
HALEY JADE LOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
4985 CLEARVIEW DR, BUFFALO, NY 14221-4161
(716) 465-5139
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
P122427
NY
Other
Enumeration date
06/28/2023
Last updated
11/11/2024
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