Organization
JONATHAN LOOMIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SNYDER LOOMIS LCSWR (CLINICAL THERAPIST)
(315) 252-6978
Entity
Organization
Contact information
Practice address
2 SOUTH ST, 204, AUBURN, NY 13021-3833
(315) 252-6978
Mailing address
2 SOUTH STREET, 204, AUBURN, NY 13021-3833
(315) 252-6978
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
R054031-1
NY
Other
Enumeration date
11/14/2011
Last updated
11/23/2011
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