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Addiction Substance Use Disorder

Ithaca, New York

Provider NPI: 1992795843

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 607-269-0187  Fax: --

Business Mailing Address:
Tel: 607-277-7363  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
N1041S0200XBehavioral Health & Social Service Providers
Social Worker


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