Individual
TAMMY NETHERCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MYGATT RD, AMENIA, NY 12501-5300
(914) 391-2603
Mailing address
109 MYGATT RD, AMENIA, NY 12501-5300
(914) 391-2603
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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