Individual
GRACE DWYER-MAURO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2 NORMANDY DR, NORTHPORT, NY 11768-3235
(631) 896-3613
Mailing address
2 NORMANDY DR, NORTHPORT, NY 11768-3235
(631) 896-3613
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
005748-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
00578-1
NY
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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