| NPI | 1740954544 |
|---|---|
| Doing Business As | SELF |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DESSI KILEY Member / Ot 917-273-8225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |