Individual
MS. KATIE ELIZABETH GADAWSKI POORMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1852 YELLOW TAVERN RD, WATERLOO, NY 13165-9772
(315) 380-7786
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1118551
NY
Other
Enumeration date
02/04/2013
Last updated
03/05/2013
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