Organization
MARRIAGE AND FAMILY THERAPY SERVICES OF THE SOUTHERN TIER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA DEVINCENTIS PHD, LMFT, BCBA (PRESIDENT)
(607) 221-5303
Entity
Organization
Contact information
Practice address
147 W GRAY ST, SUITE 217A, ELMIRA, NY 14901-3017
(607) 221-5303
(607) 723-9539
Mailing address
1 BRICK AVE, BINGHAMTON, NY 13901-2055
(607) 760-9520
(607) 723-9539
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1084739
FL
106H00000X
Marriage & Family Therapist
Primary
000960
NY
106H00000X
Marriage & Family Therapist
MF000684
PA
Other
Enumeration date
07/01/2013
Last updated
07/01/2013
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