Individual
ALEXANDRA GINA, CASSONDRA MARINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC 2
Contact information
Practice address
319 E WATER ST, SYRACUSE, NY 13202-1123
(315) 475-1771
Mailing address
7461 ELMCREST RD, LIVERPOOL, NY 13090-2848
(315) 484-0853
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32336
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271578278
—
NY
Enumeration date
02/05/2019
Last updated
02/05/2019
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