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General NPI Number Information
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NPI Number | 1023879509
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Entity Type | Individual
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Provider Name | CHLOE GRACE DOW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 4820 W TAFT RD STE 202
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City | LIVERPOOL
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State | NY
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Zip | 13088-2806
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Country | US
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Telephone | 315-552-0406
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Fax |
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Provider Business Mailing Address
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Address Line | 126 VANDERKEMP AVE
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City | BARNEVELD
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State | NY
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Zip | 13304-2427
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Country | US
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Telephone | 315-520-6371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 028377
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License Number State | NY
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