Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 82 Clark St, Moira, New York |
Authorized Official Name and Position | Diane Jean Guyette (THERAPIST) |
Authorized Official Contact | 5185290951 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
82 Clark St Moira NY 12957-2212 Ph: (518) 529-0951 | 82 Clark St Moira NY 12957-2212 Ph: (518) 529-0951 |
NPI Number | 1447322649 |
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Provider Enumeration Date | 11/14/2006 |
Last Update Date | 07/07/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447322649 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |