Individual
MS. JOAN CARROLL HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1585 MILITARY TPKE, PLATTSBURGH, NY 12901-7457
(518) 561-0100
Mailing address
1230 SUNSET DR, WILLSBORO, NY 12996-3481
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005569-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005569-1
NEW YORK STATE LICENSE FOR OT
NY
Enumeration date
10/21/2010
Last updated
10/21/2010
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