Individual
SEAN VINCENT MIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
1213 COURT ST, UTICA, NY 13502-3803
(315) 478-2453
Mailing address
518 JAMES ST STE 240, SYRACUSE, NY 13203-2229
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
33082
NY
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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