Individual
MISS CARMELINA ANN VIVENZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 ROUTE 52, WALDEN, NY 12586-2255
(845) 742-5251
Mailing address
1905 ROUTE 52, WALDEN, NY 12586-2255
(845) 742-5251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
017183
NY
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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