Individual
MRS. CHANTEL MELANIE UPSON LOCKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12044 E. MAIN ST., WOLCOTT, NY 14590
(315) 923-4033
Mailing address
167 S 4TH ST, FULTON, NY 13069-1859
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
090413-1
NY
1041C0700X
Clinical Social Worker
Primary
087537
NY
Other
Enumeration date
01/02/2018
Last updated
11/08/2019
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