Individual
BRUCE GREEN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 E GENESEE ST, AUBURN, NY 13021-4040
(315) 253-9795
Mailing address
1832 STATE ROUTE 89, SENECA FALLS, NY 13148-9413
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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