Individual
GILES SIEBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
213 YALE AVE, SYRACUSE, NY 13219-2651
(315) 925-6113
(607) 299-4349
Mailing address
213 YALE AVE, SYRACUSE, NY 13219-2651
(315) 925-6113
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001657
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001657
MARRIAGE AND FAMILY THERAPIST LICENSE
NY
05
—
1336163963
—
NY
Enumeration date
08/11/2015
Last updated
11/22/2023
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