INVOICE by durmaotr

VIEWS: 151 PAGES: 1

									                                                  INVOICE #: 3




To:               Sesame Sprout, Inc.
                          th
                  96-08 57 Avenue
                  Corona, NY 11368
                  (718) 271-2294
                  (718) 595-1132 – Fax




School Name:      A Child’s Place/ Sesame Sprout
                            th
Address:          32-20 108 Street
                  East Elmhurst, NY 11369

Type of Related Service:   Occupational Therapy




Provider Name:    Durma M. Castillo, OTR/L

Address:          77-29 Parsons Blvd
                  Fresh Meadows, NY 11366
                  (718)844-7128




Service Date:                    Total No. of Hours:             Rate:               Total Due




                                                                         __________________________
                                                                           Durma M. Castillo,OTR/L

								
To top