Individual
TRAVIS JAMES FLEWELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
2435 6TH AVE, TROY, NY 12180-2227
(518) 274-5143
(518) 273-1350
Mailing address
205 DEER RUN DR APT C, HUDSON FALLS, NY 12839-2739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
31576
NY
Other
Enumeration date
01/03/2019
Last updated
12/16/2020
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