Individual
DIANA ELIZABETH MOROCHO FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8288 88TH PL FL 2, GLENDALE, NY 11385-7818
(646) 645-5813
Mailing address
8288 88TH PL FL 2, GLENDALE, NY 11385-7818
(646) 645-5813
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010900
NY
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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