Individual
MRS. LARISSA BELTRAO GOMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
522 GREGORY AVE APT B305, WEEHAWKEN, NJ 07086-5750
(646) 431-1739
Mailing address
522 GREGORY AVE APT B305, WEEHAWKEN, NJ 07086-5750
(646) 431-1739
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9147
NY
Other
Enumeration date
04/18/2007
Last updated
12/09/2014
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