Individual
MRS. LORRI ANN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5600 SR 81, GREENVILLE, NY 12083
(518) 966-4503
Mailing address
5600 SR 81, GREENVILLE, NY 12083
(518) 966-4503
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
64003148
NY
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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