Individual
JASON ANTHONY AGNELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4535 SOUTHWESTERN BLVD STE 807, HAMBURG, NY 14075-1860
(716) 980-1885
Mailing address
213 KIRBY AVE, LACKAWANNA, NY 14218-3155
(716) 997-1001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
10/31/2022
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