Individual
BETHANY ALYSE HASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2615 N MAPLE AVE, ASHVILLE, NY 14710-9553
(716) 763-1801
Mailing address
1286 SOUTHWESTERN DR, JAMESTOWN, NY 14701-9430
(716) 338-6646
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
018279
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018279-1
NEW YORK STATE LICENSE
NY
Enumeration date
05/01/2018
Last updated
05/01/2018
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