Healthcare Provider Details

I. General information

NPI: 1619164837
Provider Name (Legal Business Name): KASANDRAE LYNN MESSE BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N MAIN ST
WARSAW NY
14569-1023
US

IV. Provider business mailing address

90 N PEARL ST
ATTICA NY
14011-1138
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-8133
  • Fax: 585-786-9928
Mailing address:
  • Phone: 585-591-0629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: