Individual
MRS. JULIE MARGARET FASOLINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
13 PARK LAWN DR, BETHEL, CT 06801-1043
(203) 830-4180
Mailing address
4 VERVALEN DR, POUGHKEEPSIE, NY 12603-6329
(845) 486-9084
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
001154
CT
225XN1300X
Neurorehabilitation Occupational Therapist
001154
CT
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
001154
CT
Other
Enumeration date
09/01/2011
Last updated
09/01/2011
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