Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1245431345 |
---|---|
Provider Name | Ms. Colleen Elizabeth Davis SR. |
First Address | Syracuse, NY 13206-3439 |
Second Address | Syracuse, NY 13210-1811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 08/07/2007 |