Individual
MS. BETH A CANOUSE-MIDURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
201 EAST GREEN ST, ITHACA, NY 14850
(607) 274-6200
(607) 274-6316
Mailing address
201 EAST GREEN ST, ITHACA, NY 14850
(607) 274-6200
(607) 274-6316
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
R0380751
NY
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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