Individual
GAUVIN LEAR ARENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 LENOX AVE, ONEIDA, NY 13421-1522
(315) 271-1883
Mailing address
550 LENOX AVE, ONEIDA, NY 13421-1522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36778
NY
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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