Individual
CHALET DEWEY-FLINT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
170 W 1ST ST S, FULTON, NY 13069-2231
(315) 593-4847
Mailing address
50 LAKESHORE RD, OSWEGO, NY 13126-6094
(315) 593-4847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R071406
NY
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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