Individual
SHANNON VICTORIA DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 N MAIN ST, CORTLAND, NY 13045
(607) 753-0234
Mailing address
5776 HOWELL RD, LOCKE, NY 13092
(607) 423-9304
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401477
NY
Other
Enumeration date
06/27/2012
Last updated
09/25/2013
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