Maryjane Quenneville
Social Worker, Clinical in Syracuse, NY. Individual provider (NPI-1).
NPI number1003587643
StatusActive
Last updated in NPPESMar 13, 2023
Details
- NPI
- 1003587643
- Entity type
- Individual (NPI-1)
- Name
- Maryjane Quenneville
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 23, 2021
- Certification date
- Mar 13, 2023
- Last updated
- Mar 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 085429 | NY | Yes |
Practice location
124 Northern Lights Dr Ste 20Syracuse, NY 13212-4119
Phone 315-326-1008
Mailing address
124 Northern Lights Dr Ste 20Syracuse, NY 13212-4119
Phone 315-326-1008
Other practice locations
9430 Birch Tree Rd
Brewerton, NY 13029-9407
Brewerton, NY 13029-9407
Phone 315-729-3701
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