Individual
CHRISTINA A. MENICHELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
1062 STATE ROUTE 38, OWEGO, NY 13827
(607) 687-4000
(607) 687-6396
Mailing address
1062 STATE ROUTE 38, PO BOX 177, OWEGO, NY 13827-3209
(607) 687-4000
(607) 687-6396
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
207663
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00618162
—
NY
01
—
207663
NCC CERTIFICATE NUMBER
—
Enumeration date
01/30/2007
Last updated
10/01/2007
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