Individual
MRS. NANCY JEAN ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2495 MAIN ST, SUITE 234, BUFFALO, NY 14214-2152
(716) 829-5929
Mailing address
2495 MAIN ST STE 234, BUFFALO, NY 14214-2152
(716) 836-5929
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002822-1
NY
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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