Healthcare Provider Details

I. General information

NPI: 1194560375
Provider Name (Legal Business Name): MARIAH LEE SCRITCHFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 HARLEM RD
WEST SENECA NY
14224-1008
US

IV. Provider business mailing address

390 RICHMOND AVE
BUFFALO NY
14222-2351
US

V. Phone/Fax

Practice location:
  • Phone: 716-827-9462
  • Fax:
Mailing address:
  • Phone: 716-544-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: