Individual
MARY COULON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1456 RIDGE RD, WEBSTER, NY 14580-3619
(585) 545-4861
Mailing address
310 BROOKSBORO DR, WEBSTER, NY 14580-9733
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/04/2012
Last updated
03/02/2020
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