Individual
MRS. DOREEN M COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
515 MOE RD, CLIFTON PARK, NY 12065-3821
(518) 280-4294
(518) 280-4297
Mailing address
515 MOE RD, CLIFTON PARK, NY 12065-3821
(518) 280-4294
(518) 280-4297
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007920-1
NY
Other
Enumeration date
11/10/2008
Last updated
03/17/2018
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