Individual
MRS. JENNIFER ANN MACIAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
455 CENTRAL AVE, LANCASTER, NY 14086-1252
(716) 681-0454
Mailing address
455 CENTRAL AVE, LANCASTER, NY 14086-1252
(716) 681-0454
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004120-1
NY
Other
Enumeration date
02/09/2011
Last updated
09/27/2011
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