Individual
SHAFICIA DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
Mailing address
126 ELMHURST AVE, SYRACUSE, NY 13207-1935
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/14/2020
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