Individual
JACLYN MARIE BOGDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2626 GENESEE ST, UTICA, NY 13502-6003
(315) 724-5344
Mailing address
131 STERLING DR, UTICA, NY 13502-7739
(315) 991-0037
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11621-01
NY
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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