Individual
SUSAN CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Mailing address
1041 CHURCH ST, CORTLAND, NY 13045-9442
(607) 423-0490
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
NY
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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