Individual
MRS. BRENDA MARIE JOCK DEROUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CAS
Contact information
Practice address
21638 REED RD, WATERTOWN, NY 13601-5048
(315) 786-0677
(315) 836-3782
Mailing address
14702 MILITARY RD, SACKETS HARBOR, NY 13685-2162
(315) 646-7074
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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