Individual
TIFFANY POLLACK GUENTHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
7000 E GENESEE ST STE D3, FAYETTEVILLE, NY 13066-1130
(917) 495-4575
Mailing address
103 ACADEMY ST, MANLIUS, NY 13104-1901
(917) 495-4575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
002572-01
NY
221700000X
Art Therapist
Primary
002572-01
NY
251S00000X
Community/Behavioral Health Agency
002572-01
NY
Other
Enumeration date
08/30/2021
Last updated
02/07/2023
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