Individual
ANNE LOUISE FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1159 E UNION ST APT 1, NEWARK, NY 14513-9201
(315) 882-4843
Mailing address
1159 E UNION ST, NEWARK, NY 14513-9201
(315) 882-4843
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
088130-1
NY
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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