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Individual

DR. MARY ANN YACONIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
458 OLD NISKAYUNA RD, LATHAM, NY 12110-1569
(518) 867-9118
Mailing address
458 OLD NISKAYUNA RD, LATHAM, NY 12110-1569
(518) 867-9118

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
004024
NY

Other

Enumeration date
08/18/2010
Last updated
08/18/2010
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