AMBRYEL MARIE MODER

MIDDLE ISLAND, NY
NPI1124546155
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: NY  022276)
Additional Taxonomies225X00000X Occupational Therapist
(Licence: NY  P07796)
Enumeration Date2017-08-30
Last Update Date2018-03-17
Business Address
AMBRYEL MARIE MODER
35 LONGWOOD RD
MIDDLE ISLAND, NY 11953-2045
Phone number: 631-924-0008
Mailing Address
AMBRYEL MARIE MODER
35 LONGWOOD RD
MIDDLE ISLAND, NY 11953-2045
Phone number: 631-924-0008