Individual
JACQUELINE K SCANLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10B MADISON AVENUE EXT, ALBANY, NY 12203-7314
(518) 867-3061
Mailing address
PO BOX 30, SALEM, NY 12865-0030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010383
NY
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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