Individual
HALIE SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5355 W TAFT RD, NORTH SYRACUSE, NY 13212-2767
(315) 218-2100
Mailing address
107 KENDALL DR W, EAST SYRACUSE, NY 13057-2629
(315) 558-1663
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
63 019142
NY
Other
Enumeration date
05/25/2016
Last updated
05/25/2016
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