MS. Telisa T Wardlaw, OTR

NPI #1164588158 in Rosedale, New York

Provider Information

NPI Number: 1164588158
Entity Type: Individual
Name: MS. Telisa T Wardlaw, OTR
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OTR
Enumeration Date: Dec 28, 2006
Last Updated: Jan 19, 2012

Practice Location

Address: 220-28 147TH AVENUE
City: Rosedale
State: New York
ZIP Code: 11413
Phone: (718) 276-1600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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