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Individual

NICOLE DEFURIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
819 S. SALINA STREET, SYRACUSE, NY 13202
(315) 476-7921
(315) 475-1448
Mailing address
819 S. SALINA STREET, SYRACUSE, NY 13202
(315) 476-7921
(315) 475-1448

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
076245
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04125137
NY
Enumeration date
02/26/2010
Last updated
03/30/2016
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