Organization
SAMARITAN LICENSED CLINICAL SOCIAL WORK, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH LEE VALIQUETTE (OFFICE MANAGER)
(518) 374-3514
Entity
Organization
Contact information
Practice address
220 N BALLSTON AVE, SCOTIA, NY 12302-2533
(518) 374-3514
(518) 374-9193
Mailing address
220 N BALLSTON AVE, SCOTIA, NY 12302-2533
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P71596
NY
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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