Individual
MISS CARRIE MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
21405 18TH AVE, 3RD APT, BAYSIDE, NY 11360-1604
(718) 690-0566
Mailing address
21405 18TH AVE, 3RD APT, BAYSIDE, NY 11360-1604
(718) 690-0566
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
019380
NY
225XP0200X
Pediatric Occupational Therapist
Primary
019380
NY
Other
Enumeration date
07/17/2015
Last updated
01/07/2016
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