Doctor Name: | SANDRA RYANT-DEVINE |
NPI Number: | 1043359987 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | R025296-1 |
Business Practice Address: | 100 John Roemmelt Dr Horseheads, NY - 148458301 |
Business Phone Number: | 6077965936 |
Business Fax Number: | 6077396435 |
Mailing Address: | 722 W Water St, ELMIRA |
State: | NY |
Postal Code: | 149052435 |
Phone Number: | 6072712050 |
Fax Number: | 6072712099 |
NPI Enumeration Date: | 02/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R025296-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |