Individual
GIESELLE TAKEISHA BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
16 MELODY LN, AMITYVILLE, NY 11701-1618
(347) 424-1169
(631) 608-8264
Mailing address
16 MELODY LN, AMITYVILLE, NY 11701-1618
(347) 424-1169
(631) 608-8264
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
015716
NY
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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