Individual
CAROLYN JEAN FAGNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3495 BAILEY AVE, BUFFALO, NY 14215-1129
(716) 392-1910
Mailing address
3495 BAILEY AVE, BUFFALO, NY 14215-1129
(716) 392-1910
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW25492
CA
Other
Enumeration date
05/29/2007
Last updated
12/12/2023
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