Individual
KATHLEEN DORMER BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
29 PINEWOOD DR, COMMACK, NY 11725-5612
(631) 499-1074
Mailing address
82 LOU AVE, KINGS PARK, NY 11754-1507
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005671-1
NY
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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