Individual
JESSICA BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
611 BROADWAY RM 901, NEW YORK, NY 10012-2630
(212) 473-0011
Mailing address
PO BOX 147, NEW YORK, NY 10272-0147
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
023645
NY
225XH1200X
Hand Occupational Therapist
Primary
023645
NY
Other
Enumeration date
08/12/2019
Last updated
03/26/2020
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