Individual
MS. KIM ANN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1210 PURITAN AVE, BRONX, NY 10461-6153
(718) 892-8995
Mailing address
1210 PURITAN AVE, BRONX, NY 10461-6153
(718) 892-8995
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007772
NY
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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