Individual
JILLIAN MAXFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Mailing address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
(315) 422-4855
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
023807-01
NY
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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