Individual
MRS. GLORIA CANDACE MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2005 SHERIDAN DR, BUFFALO, NY 14223-1222
(716) 694-6939
Mailing address
4036 CRESCENT DR, NORTH TONAWANDA, NY 14120-1365
(716) 694-6939
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
000200-1
NY
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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