Individual
DAWN RELATION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 FRANKLIN ST, SCHENECTADY, NY 12305-2107
(518) 372-7031
(518) 372-7064
Mailing address
PO BOX 10547, ALBANY, NY 12201-5547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24911
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
04/04/2016
Last updated
04/04/2016
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