Individual
MS. BROOKLEIGH RENNE MANIOCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
Mailing address
34 ILLINOIS ST, ROCHESTER, NY 14609-7433
(585) 944-0733
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007419-1
NY
Other
Enumeration date
10/05/2010
Last updated
02/03/2020
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