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NPI Code Detail

MEDICARE: MARILYN AGNES BABCOCK LCSW

MEDICARE:   MARILYN AGNES BABCOCK  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerR053349-1NY

General Provider Information

NPI Number : 1770636078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN AGNES BABCOCK LCSW
Provider Business Mailing Address
First Line : 12 WATSON ST
Second Line :
City : UNADILLA
State : NY
Zip : 13849-0730
Country : US
Telephone Number : 607-369-3902
Fax Number :
Provider Business Practice Location Address
First Line : 12 WATSON ST
Second Line :
City : UNADILLA
State : NY
Zip : 13849-0730
Country : US
Telephone Number : 607-369-3902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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Directions to “ MARILYN AGNES BABCOCK LCSW” Practice Location

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