Individual
CHANEL BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 EDGERTON ST APT B8, MINOA, NY 13116-1448
(315) 726-0313
Mailing address
500 EDGERTON ST APT B8, MINOA, NY 13116-1448
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103268
NY
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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