Individual
MS. ELIZABETH ANNE GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
204 MARTIN RD, LAGRANGEVILLE, NY 12540-6348
(845) 223-9808
Mailing address
204 MARTIN RD, LAGRANGEVILLE, NY 12540-6348
(845) 223-9808
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
006474-2
NY
Other
Enumeration date
03/19/2009
Last updated
03/19/2009
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