Individual
MRS. LAURIE VIRGINIA VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1277 TAYLOR RD, OWEGO, NY 13827-1200
(607) 687-8929
Mailing address
16 S WOODHILL AVE, BINGHAMTON, NY 13904-2726
(607) 775-1451
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
066621-1
NY
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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