Individual
TEDESSA MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
257 MAIN ST, BINGHAMTON, NY 13905
(607) 729-6206
Mailing address
165 MAIN ST., STE A, CORTLAND, NY 13045-3049
(607) 753-0234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
090153
NY
101Y00000X
Counselor
Primary
091900
NY
Other
Enumeration date
02/06/2017
Last updated
09/15/2021
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