Individual
SUSAN LYNN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 MATTHEWS ST, GOSHEN, NY 10924-1962
(845) 294-5124
Mailing address
PO BOX 647, FORT MONTGOMERY, NY 10922-0647
(845) 656-5461
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
108154
NY
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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