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Individual

MS. ANN E. BADGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
403 TULIP ST, LIVERPOOL, NY 13088-4966
(315) 451-2318
Mailing address
121 IROQUOIS LN, LIVERPOOL, NY 13088-4447
(315) 451-5192

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 11396
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0087029
GHI PIN
NY
05
02304350
NY
01
11514472
CAQH PROVIDER ID
NY
Enumeration date
03/29/2007
Last updated
07/09/2007
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