Individual
JENNIFER CLEMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 FRANKLIN ST STE 204, SCHENECTADY, NY 12305-2100
(518) 372-7031
(518) 372-7064
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
(518) 952-8408
(518) 399-6860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
11/13/2017
Last updated
11/13/2017
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