Individual
MRS. REGINA MARIE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
750 HICKSVILLE RD, SEAFORD, NY 11783-1328
(516) 804-9362
Mailing address
750 HICKSVILLE RD, SEAFORD, NY 11783-1328
(516) 804-9362
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
011834-1
NY
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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