Individual
TREVOR BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 PARK ST, MALONE, NY 12953-1228
(518) 483-2070
Mailing address
209 PARK ST, MALONE, NY 12953-1228
(518) 483-2070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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