Individual
MR. JASON WILLIAM ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SPECIAL EDUCATION
Contact information
Practice address
72 S MAIN ST, CASTILE, NY 14427-9604
(585) 217-7698
Mailing address
72 S MAIN ST, CASTILE, NY 14427-9604
(585) 217-7698
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1733233
NY
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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