Individual
DYLAN S MARIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LMHC
Contact information
Practice address
20 OFFICE PARK WAY STE 107, PITTSFORD, NY 14534
(585) 200-4646
Mailing address
5 STARLIGHT CIR, FAIRPORT, NY 14450-9330
(585) 200-4646
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
002604
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
543015-1
NY
Other
Enumeration date
08/13/2008
Last updated
04/10/2020
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