Individual
JANAY JASMINE SMALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 IRVING AVE, SYRACUSE, NY 13210-2343
(315) 426-7640
Mailing address
236 WAYLAND RD, SYRACUSE, NY 13208-3316
(315) 560-1228
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
669390
NY
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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