Individual
MARY JO SALOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 LAKEHILL RD, BALLSTON LAKE, NY 12019-2429
(518) 399-9141
(518) 399-0343
Mailing address
25 LAKEHILL RD, BALLSTON LAKE, NY 12019-2429
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
011882-1
NY
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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