Individual
LAURA VANESA GRUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 BATH AVE, BROOKLYN, NY 11214-4613
(718) 238-4637
Mailing address
34-43 60TH STREET, APT 4J, WOODSIDE, NY 11377-2120
(718) 505-1482
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007850-1
NY
Other
Enumeration date
03/22/2011
Last updated
04/28/2011
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