Individual
MRS. MARY ELLEN ELIZABETH ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
46 TEAKETTLE SPOUT RD, MAHOPAC, NY 10541-4237
(191) 794-1037
Mailing address
46 TEAKETTLE SPOUT RD, MAHOPAC, NY 10541-4237
(191) 794-1037
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
006720-1
NY
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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