Individual
MS. PATRICIA MARY SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-BC, LCAT, CASAC
Contact information
Practice address
116 PRIMROSE LN, NORTH SYRACUSE, NY 13212-4230
(315) 457-2107
Mailing address
116 PRIMROSE LN, NORTH SYRACUSE, NY 13212-4230
(315) 457-2107
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
ATR-BC 92-321
NY
Other
Enumeration date
02/11/2007
Last updated
07/08/2007
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