Individual
CANDACE LEOTTA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
121 LAKE ST, BROOKLYN, NY 11223-2734
(718) 645-6488
(718) 645-6579
Mailing address
983 ROGERS AVE, BROOKLYN, NY 11226-5416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005076-1
NY
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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