Individual
MRS. KIM MARIE HAYDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATR-BC,LCAT
Contact information
Practice address
4513 OLD VESTAL RD, VESTAL, NY 13850-3571
(607) 760-9153
Mailing address
4 MAPLE AVE, ENDICOTT, NY 13760-6222
(607) 760-9153
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001019
NY
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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