Individual
MRS. KELLY ANNE HIRSCHBOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689
Mailing address
3885 PROSPECT ST., ONEIDA, NY 13421-5202
(315) 269-4462
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
017502-1
NY
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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