Individual
ATHENA ACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
76 VETERANS AVE, BATH, NY 14810-0810
(607) 664-4365
Mailing address
76 VETERANS AVE BLDG 30, BATH, NY 14810-0810
(607) 664-4365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
091253
NY
Other
Enumeration date
10/09/2019
Last updated
03/07/2023
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