Individual
GRACE LIM MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5454 83RD ST, ELMHURST, NY 11373-4744
(909) 991-5214
Mailing address
5454 83RD ST, ELMHURST, NY 11373-4744
(909) 991-5214
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
015893-1
NY
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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