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Individual

MS. SANDRA MOBLEY-TERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CASAC

Contact information

Practice address
951 NIAGARA STREET, ADOLESCENT OUTPATIENT PROGRAM, BUFFALO, NY 14213
(716) 883-5344
(716) 884-1758
Mailing address
FRANKLIN ST, 254 FRANKLIN STREET, BUFFALO, NY 14202-4107
(716) 842-0440
(716) 842-4069

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8241
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8241
CASAC
NY
Enumeration date
02/27/2008
Last updated
02/27/2008
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