Individual
ATIYANA IVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 CHENANGO ST, BINGHAMTON, NY 13901-2312
(607) 304-5521
Mailing address
275 CHENANGO ST, BINGHAMTON, NY 13901-2312
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/14/2021
Last updated
04/19/2023
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