Healthcare Provider Details

I. General information

NPI: 1417169293
Provider Name (Legal Business Name): MICHELE ANN SEXSMITH M.S., LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE ANN STRAZZERI M.S.,LCAT

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 PRINCETON AVENUE EXT
CORNING NY
14830-1524
US

IV. Provider business mailing address

1486 LAUREL LN
HORNELL NY
14843-1135
US

V. Phone/Fax

Practice location:
  • Phone: 607-962-3148
  • Fax: 607-962-8422
Mailing address:
  • Phone: 607-324-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number05-000463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: