Individual
MRS. TRACI JAMROGA GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53 GIBSON ROAD, GOSHEN, NY 10925
(845) 291-0200
Mailing address
132 OLSEN CT, MONTGOMERY, NY 12549-1736
(845) 649-5784
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006919-1
NY
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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