Individual
JILLIAN E VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
76 VETERANS AVE BLDG 92, BATH, NY 14810-0810
(607) 664-4694
Mailing address
160 UPPER DELEVAN AVE, CORNING, NY 14830-3267
(607) 684-7506
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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