Individual
JANICE GULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
82 MEADOWMERE AVE, MASTIC, NY 11950-4606
(631) 924-4411
Mailing address
82 MEADOWMERE AVE, MASTIC, NY 11950-4606
(631) 924-4411
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
03/31/2010
Last updated
03/31/2010
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