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Individual

DOROTHY ADHIAMB0 MAUNDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
84 WAVERLY ST, POTSDAM, NY 13676-1607
(315) 261-3541
Mailing address
77 W BARNEY ST, GOUVERNEUR, NY 13642-1040
(315) 287-1000

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403984-01
NY

Other

Enumeration date
02/04/2022
Last updated
05/06/2022
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