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Individual

MS. CRYSTAL ANN CONSALVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOTR/L

Contact information

Practice address
710 LONG RIDGE RD, STAMFORD, CT 06902-1226
(203) 329-4026
Mailing address
17 BRASSWOOD RD, SAINT JAMES, NY 11780-3411
(631) 786-8185

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
63015038
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
63015038
OCCUPATIONAL THERAPIST NY LICENSE NUMBER
NY
Enumeration date
02/02/2011
Last updated
02/02/2011
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