Individual
MRS. BERENICE MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3989 51ST ST, 3I, WOODSIDE, NY 11377-3157
(718) 813-3804
Mailing address
3989 51ST ST, 3I, WOODSIDE, NY 11377-3157
(718) 813-3804
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007585-1
NY
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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