Individual
THERESA MARIE DYER SERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
784531
NY
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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