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Ms. Jennifer M Gotham
Addiction (Substance Use Disorder) Counselor in Canton, New York
NPI 1174644223

Jennifer M Gotham is an Addiction (Substance Use Disorder) Counselor based in Canton, NY and is specialized in Addiction (Substance Use Disorder). Jennifer M Gotham practices in Canton, NY. The NPI Number for Jennifer M Gotham is 1174644223 and holds a License No. (New York).

The current practice location address for Jennifer M Gotham is 80 State Highway 310, Canton, NY and can be reached out via phone at 315-386-2189 and via fax at 315-386-2435.

Location: 80 State Highway 310, Canton, NY, 13617-1493
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174644223
Provider Name
Jennifer M Gotham
Credential
Provider Entity Type
Individual
Gender
Female
Address
80 State Highway 310, Canton, NY, 13617-1493
Phone Number
315-386-2189
Fax Number
315-386-2435
Provider Enumeration Date
04/03/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
80 State Highway 310
City
Canton
State
New York
Zip
13617-1493
Phone Number
315-386-2189
Fax Number
315-386-2435
person
Provider Business Mailing Address Details
Address
80 State Highway 310
City
Canton
State
New York
Zip
13617-1493
Phone Number
315-386-2189
Fax Number
315-386-2435
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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