Individual
DR. MARY ELIZABETH JEANNOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7030 E GENESEE ST, FAYETTEVILLE, NY 13066
(315) 682-0871
Mailing address
7030 E GENESEE ST, FAYETTEVILLE, NY 13066
(315) 682-0871
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0122191
NY
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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