Individual
SHASTA DANIELLE TREADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
243 DELAWARE ST, WALTON, NY 13856-1019
(607) 832-5888
(607) 832-6081
Mailing address
243 DELAWARE ST, WALTON, NY 13856-1019
(607) 832-5888
(607) 832-6081
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404416
NY
Other
Enumeration date
09/19/2022
Last updated
04/02/2026
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