Individual
AMANDA LYN CRUIKSHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 MAIN ST, UTICA, NY 13501-1236
(315) 792-9039
Mailing address
1129 E GERMAN STREET EXT, HERKIMER, NY 13350-3909
(315) 868-3568
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
094455
NY
Other
Enumeration date
05/15/2013
Last updated
05/05/2023
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