Individual
AUTUMN RASCHEL EDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 EAST AVE, SINCLAIRVILLE, NY 14782-9722
(716) 338-2413
Mailing address
21 EAST AVE, SINCLAIRVILLE, NY 14782-9722
(716) 338-2413
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
344868
NY
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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