Individual
DOREEN LOUISE KEPHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
5860 SPRINGHOUSE RD, ROME, NY 13440-7859
(315) 292-3511
Mailing address
5860 SPRINGHOUSE RD, ROME, NY 13440-7859
(315) 292-3511
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
390524911
NY
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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