Individual provider · Type 1 NPI
Jennifer M. Gotham
Addiction (Substance Use Disorder) Counselor · Canton, NY
NPI number
1174644223
Active
Practice location
80 State Highway 310, Suite 1
Canton, NY 13617-1493
Fax (315) 386-2435
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1174644223
Jennifer M. Gotham's National Provider Identifier is 1174644223, issued on Apr 3, 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 8, 2007.