Individual
EH MOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1213 COURT ST, UTICA, NY 13502-3803
(315) 624-9835
(315) 624-9835
Mailing address
1213 COURT ST STE 100, UTICA, NY 13502-3803
(315) 624-9835
(315) 624-9835
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Enumeration date
06/13/2025
Last updated
06/13/2025
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