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General NPI Number Information
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NPI Number | 1114645066
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Entity Type | Organization
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Legal Business Name | IN YOUR OWN WAY LLC
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 100 OLD HOJACK LN
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City | HILTON
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State | NY
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Zip | 14468-1100
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Country | US
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Telephone | 585-431-6696
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Fax |
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Provider Business Mailing Address
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Address Line | 100 OLD HOJACK LN
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City | HILTON
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State | NY
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Zip | 14468-1100
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Country | US
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Telephone | 585-431-6696
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MEGHAN ROE
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Credential |
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Telephone | 617-674-3499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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