Individual
HOLLY DEMAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
257 MAIN ST, BINGHAMTON, NY 13905-2522
(607) 629-6206
Mailing address
165 MAIN ST, STE A, CORTLAND, NY 13045-3049
(607) 753-0234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
108300
NY
Other
Enumeration date
09/23/2019
Last updated
11/13/2019
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