Healthcare Provider Details

I. General information

NPI: 1831343540
Provider Name (Legal Business Name): THERESE R ALLEN MS/ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 N MAIN ST
SPRING VALLEY NY
10977-1902
US

IV. Provider business mailing address

23 RENFREW RD
CHESTNUT RIDGE NY
10977-6905
US

V. Phone/Fax

Practice location:
  • Phone: 845-352-7140
  • Fax: 845-352-7150
Mailing address:
  • Phone: 845-623-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number014738-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: