Individual
MS. GERALDINE LEGEORGIA MOWATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
63 BIRCHWOOD DR S, VALLEY STREAM, NY 11580-1941
(516) 812-8549
Mailing address
63 BIRCHWOOD DR S, VALLEY STREAM, NY 11580-1941
(516) 812-8549
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
002446-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
002446-1
NY
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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