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Individual

MR. ERIC THOMAS KINGSBURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CASAC T

Contact information

Practice address
3020 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 833-3622
Mailing address
52 TUSCARORA RD, BUFFALO, NY 14220-2028
(716) 572-2479

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21569
NY

Other

Enumeration date
03/05/2008
Last updated
03/05/2008
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