Healthcare Provider Details

I. General information

NPI: 1285883108
Provider Name (Legal Business Name): BETH ANN GRIER-LEVA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 COLEBROOK DR
ROCHESTER NY
14617-2211
US

IV. Provider business mailing address

41 COLEBROOK DR
ROCHESTER NY
14617-2211
US

V. Phone/Fax

Practice location:
  • Phone: 585-467-4567
  • Fax: 585-467-6973
Mailing address:
  • Phone: 585-467-4567
  • Fax: 585-467-6973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number042976-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: