Individual
JILL MATTISON AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 CATHERWOOD RD, ITHACA, NY 14850-1071
(607) 227-4421
Mailing address
519 SCOFIELD RD, GROTON, NY 13073-9737
(607) 227-8180
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
504615
NY
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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