Provider Demographics
NPI:1376817106
Name:TOUSSAINT, VIOLENE (OTA)
Entity Type:Individual
Prefix:
First Name:VIOLENE
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LYON ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3101
Mailing Address - Country:US
Mailing Address - Phone:516-612-2830
Mailing Address - Fax:516-612-2830
Practice Address - Street 1:211 LYON ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3101
Practice Address - Country:US
Practice Address - Phone:516-612-2830
Practice Address - Fax:516-612-2830
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003860224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant