Doctor Name: | MS. KIMBERLY ANNE PUETZER-GOWING |
NPI Number: | 1629005616 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW-R |
License Number: | 071148 |
Business Practice Address: | 138 North Court Street Madison Co. Mental Health Dept Veterans Memorial Building Wampsville, NY - 131630608 |
Business Phone Number: | 3153662327 |
Business Fax Number: | 3153662599 |
Mailing Address: | 138 North Court Street Madison Co. Mental Health Dept, Veterans Memorial Building WAMPSVILLE |
State: | NY |
Postal Code: | 131630608 |
Phone Number: | 3153662327 |
Fax Number: | 3153662599 |
NPI Enumeration Date: | 06/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 071148 |
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 |