Individual
MRS. COLLEEN O'CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2277 GOSHEN TPKE, MIDDLETOWN, NY 10941-4032
(845) 692-4391
Mailing address
2277 GOSHEN TPKE, MIDDLETOWN, NY 10941-4032
(845) 692-4391
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008250
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224Z00000X
O.T. ASSISTANTS
NY
Enumeration date
11/03/2014
Last updated
11/03/2014
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