Individual
MARY ST JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 OVERLOOK AVE, BEACON, NY 12508-2606
(646) 594-4225
Mailing address
18 OVERLOOK AVE, BEACON, NY 12508-2606
(646) 594-4225
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008508-1
NY
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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