Individual
MR. JARID ISAIAH CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC #31237
Contact information
Practice address
585 JOSEPH AVE, ROCHESTER, NY 14605-1215
(585) 325-4910
(585) 546-1491
Mailing address
152 BADEN ST, ROCHESTER, NY 14605-2054
(585) 325-4910
(585) 546-1491
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
321237
NY
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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