Doctor Name: | MR. JEFFREY JACOB SYMESLATINI |
NPI Number: | 1124240072 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 6666 County Route 11 Bath, NY - 148107722 |
Business Phone Number: | 6077763822 |
Business Fax Number: | |
Mailing Address: | 46 Maple St, HORNELL |
State: | NY |
Postal Code: | 148431621 |
Phone Number: | 6073241531 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |