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NPI 1265466601

NPI 1265466601 : MARGARET A NEZELEK LCSW : SIDNEY, NY

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General NPI Number Information
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    NPI Number           |    1265466601
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    Entity Type          |    Individual 
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    Provider Name        |    MARGARET A NEZELEK LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/10/2006
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    Last Update Date     |    02/11/2010
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Provider Practice Location Address
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    Address Line         |    76 MAIN ST SUITE B
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    City                 |    SIDNEY
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    State                |    NY
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    Zip                  |    13838-1112
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    Country              |    US
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    Telephone            |    607-563-4080
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    Fax                  |    607-563-4080
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Provider Business Mailing Address
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    Address Line         |    76 MAIN ST SUITE B
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    City                 |    SIDNEY
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    State                |    NY
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    Zip                  |    13838-1112
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    Country              |    US
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    Telephone            |    607-563-4080
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    Fax                  |    607-563-4080
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    R0440551
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    License Number State |    NY
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