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General NPI Number Information
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NPI Number | 1770836835
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Entity Type | Individual
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Provider Name | DIANE L. DESMOND M.S., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 274 HAYES RD
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City | SCHUYLERVILLE
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State | NY
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Zip | 12871-1840
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Country | US
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Telephone | 518-538-3510
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Fax |
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Provider Business Mailing Address
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Address Line | 45 BAYBERRY DR
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City | MALTA
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State | NY
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Zip | 12020-6307
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Country | US
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Telephone | 518-581-8085
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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 | 010034-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 010034-1
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License Number State | NY
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