Individual
SHAQUAH WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1051 59TH ST, BROOKLYN, NY 11219-4825
(718) 437-5774
Mailing address
1051 59TH ST, BROOKLYN, NY 11219-4825
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
016055
NY
Other
Enumeration date
06/24/2010
Last updated
11/10/2010
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