Individual
MS. JACQUELINE FAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-6418
Mailing address
1725 STERLING PL APT 3B, BROOKLYN, NY 11233-4520
(347) 683-9956
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
NY
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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