Individual
CARLENE L CHILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
270 LAKE ST, PENN YAN, NY 14527-1832
(315) 536-2601
(315) 536-1171
Mailing address
270 LAKE ST, PENN YAN, NY 14527-1832
(315) 536-2601
(315) 536-1171
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
016738-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225X00000X
OCCUAPTIONAL THERAPY
NY
Enumeration date
08/01/2011
Last updated
08/01/2011
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