Individual
JIBRAIL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3505 AVENUE S, BROOKLYN, NY 11234-4827
(718) 787-1772
Mailing address
13015 223RD ST, LAURELTON, NY 11413-1243
(718) 785-3911
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0082071
NY
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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