Individual
TARALEE LASHWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11050 MT BELVEDERE BLVD, FORT DRUM, NY 13602-2603
(315) 772-3778
Mailing address
P36 FIRST STREET W, FORT DRUM, NY 13602-2603
(315) 772-3778
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
31808
NY
106H00000X
Marriage & Family Therapist
Primary
001079
NY
Other
Enumeration date
11/21/2013
Last updated
10/04/2024
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