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Individual

MS. CHRISTINE ANN GUMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
777 MARYVALE DR, BUFFALO, NY 14225-2712
(716) 631-9515
Mailing address
777 MARYVALE DR, BUFFALO, NY 14225-2712

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
016988-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
688564
NY
Enumeration date
08/15/2012
Last updated
07/29/2019
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