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General NPI Number Information
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NPI Number | 1316712490
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Entity Type | Individual
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Provider Name | COURTNEY CIRAOLO MHC-P
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 531 FARBER LAKES DR STE 201
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City | BUFFALO
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State | NY
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Zip | 14221-5773
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Country | US
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Telephone | 716-895-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 124 SABLE PALM DR UPPR
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City | BUFFALO
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State | NY
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Zip | 14225-5223
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Country | US
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Telephone |
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Fax |
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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 | P117116
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License Number State | NY
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