Individual
JOHANNA GASPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4204 25TH AVE APT 2, ASTORIA, NY 11103-2503
(631) 805-1870
Mailing address
4204 25TH AVE APT 2, ASTORIA, NY 11103-2503
(631) 805-1870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
P14447
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P14447
OT ASSISTANT
NY
Enumeration date
02/25/2019
Last updated
02/25/2019
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