Individual
MS. CRYSTAL JANINE GOBERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
920 BAYCHESTER AVE APT 23H, BRONX, NY 10475-1755
(646) 271-6019
Mailing address
920 BAYCHESTER AVE APT 23H, BRONX, NY 10475-1755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
023573
NY
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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