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Individual

MRS. NICOLEA ALICIA HUDSON-JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AAS

Contact information

Practice address
12952 135TH ST, SOUTH OZONE PARK, NY 11420-3542
(917) 941-8617
Mailing address
12952 135TH ST, SOUTH OZONE PARK, NY 11420-3542
(917) 941-8617

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004266
NY

Other

Enumeration date
12/13/2023
Last updated
12/13/2023
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