Individual
JESSICA HOPE WAFFLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
262 CONKLIN AVE, BINGHAMTON, NY 13903-2308
(607) 762-6062
(607) 762-8393
Mailing address
262 CONKLIN AVE, BINGHAMTON, NY 13903-2308
(607) 762-6062
(607) 762-8393
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
084927
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00583582
—
NY
Enumeration date
06/17/2010
Last updated
04/12/2018
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