Individual
JILLIAN RAE HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
7014 BIG TREE RD, PAVILION, NY 14525-9138
(585) 584-3115
Mailing address
9694 ROANOKE RD, STAFFORD, NY 14143-9536
(716) 983-8160
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
128479
NY
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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