Individual
GENIELLE WIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
38 W 32ND ST STE 604, NEW YORK, NY 10001-3884
(743) 824-8119
Mailing address
105 W 105TH ST APT 3A, NEW YORK, NY 10025-4065
(732) 824-8119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
02531001
NY
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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