Individual
MS. TARAH E. VRIESENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
220 W KENNEDY ST, SYRACUSE, NY 13205-1057
(315) 435-6000
Mailing address
220 W KENNEDY ST, SYRACUSE, NY 13205-1057
(315) 435-6000
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
002312-1
NY
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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