Individual
GABRIELLA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
77 N CENTRE AVE STE 215, ROCKVILLE CENTRE, NY 11570-3923
(631) 910-7541
Mailing address
194 W 21ST ST, HUNTINGTON STATION, NY 11746-2122
(631) 896-3670
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
028418
NY
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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