Individual provider · Type 1 NPI

Mavis A. Bush

Addiction (Substance Use Disorder) Counselor · Canton, NY

NPI number 1043400658 Active

Practice location

80 State Highway 310, Suite 1
Canton, NY 13617-1493

Call (315) 386-2189 Map

Fax (315) 386-2435

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1043400658

Mavis A. Bush's National Provider Identifier is 1043400658, issued on Jul 30, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Canton, NY. The record was last updated on Jul 30, 2007.