Individual
MRS. DIANE LYNN CLOGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6385 LOCUST STREET EXT, LOCKPORT, NY 14094-6511
(716) 478-4770
Mailing address
6385 LOCUST STREET EXT, LOCKPORT, NY 14094-6511
(716) 478-4770
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0032271
NY
Other
Enumeration date
09/14/2010
Last updated
09/23/2010
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