Individual provider · NPI-1

Kylene Margaret Roberts

Early Intervention Provider Agency · Oswego, NY

NPI number1659007235
StatusActive
Last updated in NPPESJan 8, 2024

Details

NPI
1659007235
Entity type
Individual (NPI-1)
Name
Kylene Margaret Roberts
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 27, 2022
Certification date
Jan 8, 2024
Last updated
Jan 8, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
252Y00000X Early Intervention Provider Agency––Yes

Practice location

70 Bunner St
Oswego, NY 13126-3357

Phone 315-349-8432

Mailing address

70 Bunner St
Oswego, NY 13126-3357

Phone 315-349-8432

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