Individual
GRETCHEN MAISE CLEVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-6577
Mailing address
115 LIBERTY ST, BATH, NY 14810-1508
(607) 664-6577
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
518534
NY
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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