Individual
JOHNNY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHC
Contact information
Practice address
7266 BUCKLEY RD, NORTH SYRACUSE, NY 13212-2649
(315) 458-0919
(315) 458-0954
Mailing address
7266 BUCKLEY RD, NORTH SYRACUSE, NY 13212-2649
(315) 458-0919
(315) 458-0954
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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