Individual
CAROL A BOBERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 SUNRISE TER, TRUMANSBURG, NY 14886-9102
(607) 387-4393
Mailing address
4 SUNRISE TER, TRUMANSBURG, NY 14886-9102
(607) 387-4393
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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