Individual
TANISHA GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
87 CLINTON AVE N, ROCHESTER, NY 14604-1455
(585) 546-7220
(585) 262-7198
Mailing address
87 CLINTON AVE N, ROCHESTER, NY 14604-1455
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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