Individual
KAYLEE BRIANNA FAHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4747 MIDDLE SETTLEMENT RD, NEW HARTFORD, NY 13413-4983
(315) 793-8500
Mailing address
65 ORISKANY BLVD, WHITESBORO, NY 13492-1323
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010190
NY
Other
Enumeration date
10/22/2020
Last updated
10/18/2022
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