Individual
KATELYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
62-P123083-01
NY
Other
Enumeration date
07/18/2023
Last updated
07/20/2023
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