Individual
MRS. BREYANNA MARIE LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., M.A.,LMFT
Contact information
Practice address
8195 CAZENOVIA RD # 4, MANLIUS, NY 13104-9631
(607) 426-0264
Mailing address
4144 MIDSTATE LN, CAZENOVIA, NY 13035-9436
(607) 426-0264
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001259-1
NY
Other
Enumeration date
01/25/2016
Last updated
09/17/2021
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