Individual
SASHANE O MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1339 YORK AVE, NEW YORK, NY 10021-4707
(212) 628-2800
Mailing address
212 PARK AVE, ORANGE, NJ 07050-4146
(623) 329-3956
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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