Individual
MARY SQUILLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
710 LINCOLN BLVD, LONG BEACH, NY 11561-2316
(516) 889-6939
(516) 889-6939
Mailing address
710 LINCOLN BLVD, LONG BEACH, NY 11561-2316
(516) 889-6939
(516) 889-6939
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0076971
NY
Other
Enumeration date
09/13/2008
Last updated
09/13/2008
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