Individual
DEMETRIA THATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
35 SHOTWELL AVE, STATEN ISLAND, NY 10312-1929
(917) 932-4741
Mailing address
35 SHOTWELL AVE, STATEN ISLAND, NY 10312-1929
(917) 932-4741
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
026248
NY
Other
Enumeration date
11/23/2021
Last updated
02/02/2023
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