Individual
ANNA AZALIA WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1704 STATE ST, WATERTOWN, NY 13601-3102
(315) 788-7430
(315) 785-5637
Mailing address
PO BOX 6550, WATERTOWN, NY 13601-6550
(315) 788-7430
(315) 785-5637
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3372621
—
NY
Enumeration date
01/11/2019
Last updated
01/11/2019
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