Individual
JASON ANDREW SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
72 MULBERRY ST, ROCHESTER, NY 14620-2432
(585) 208-5991
Mailing address
72 MULBERRY ST, ROCHESTER, NY 14620-2432
(585) 208-5991
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2279223
NY
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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