Organization
WELLNESS PATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAHID MASROURI LCSW-R (CEO)
(315) 457-7047
Entity
Organization
Contact information
Practice address
209 OSWEGO ST, SPACE#13, LIVERPOOL, NY 13088-1502
(315) 457-7047
(315) 457-0719
Mailing address
209 OSWEGO ST, SPACE#13, LIVERPOOL, NY 13088-1502
(315) 457-7047
(315) 457-0719
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
R046289-1
NY
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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