Individual
MRS. JENNIFER ANN BROCCULERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1085 EGGERT RD, AMHERST, NY 14226-4148
(716) 831-8422
Mailing address
1085 EGGERT RD, AMHERST, NY 14226-4148
(716) 831-8422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008167-1
NY
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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