| Hiding Place Individual Family And Marriage Therapy Pllc | |
|
1868 Niagara Falls Blvd Ste 103 Tonawanda NY 14150-6494 | |
| (716) 201-0522 | |
| Not Available |
| Full Name | Hiding Place Individual Family And Marriage Therapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1868 Niagara Falls Blvd Ste 103, Tonawanda, New York |
| Authorized Official Name and Position | Edward Jackson (MEMBER/OWNER) |
| Authorized Official Contact | 7162010522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hiding Place Individual Family And Marriage Therapy Pllc 1868 Niagara Falls Blvd Ste 103 Tonawanda NY 14150-6494 Ph: (716) 201-0522 | Hiding Place Individual Family And Marriage Therapy Pllc 1868 Niagara Falls Blvd Ste 103 Tonawanda NY 14150-6494 Ph: (716) 201-0522 |
| NPI Number | 1467239814 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 01/03/2024 |
| Certification Date | 01/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467239814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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