Individual
EDITH LUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1062 STATE ROUTE 38, OWEGO, NY 13827-0177
(607) 687-4000
Mailing address
1062 STATE ROUTE 38, OWEGO, NY 13827-3209
(607) 205-0974
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37159
NY
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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