Individual
NATHALIE JAE COLMENARES LIEBOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4277 65TH PL, WOODSIDE, NY 11377-5054
(718) 429-2000
Mailing address
5314 94TH ST, ELMHURST, NY 11373-4632
(347) 209-7567
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009334
NY
Other
Enumeration date
12/08/2016
Last updated
06/24/2017
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