Individual
IRETA LONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 NEW SCOTLAND AVE, ALBANY, NY 12208-3409
(518) 549-9600
Mailing address
75 NEW SCOTLAND AVE, ALBANY, NY 12208-3409
(518) 549-9600
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
004131
NY
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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