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Individual

MRS. CARISSA MARIE SWILLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5820 HERITAGE LANDING DR, EAST SYRACUSE, NY 13057-9378
(315) 701-1107
Mailing address
105 HATHERLEIGH RD, SYRACUSE, NY 13209-2232
(315) 430-7223

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
NY

Other

Enumeration date
08/02/2012
Last updated
08/02/2012
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