Individual
MRS. HEATHER FAWN FIACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
5300 MILITARY RD, MT. ST. MARY'S HOSPITAL ROOM 526, LEWISTON, NY 14092-1903
(716) 298-2253
(716) 298-2471
Mailing address
5300 MILITARY RD, LEWISTON, NY 14092-1903
(716) 298-2253
(716) 298-2471
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005621F
NY
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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