Individual
COURTNEY TAYLOR FORMOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3 SCHOOL DR, PENN YAN, NY 14527-1081
(315) 924-6050
Mailing address
3 SCHOOL DR, PENN YAN, NY 14527-1081
(315) 924-6050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
03/27/2026
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