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General NPI Number Information
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NPI Number | 1386661031
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Entity Type | Organization
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Legal Business Name | ROME EVALUATION & THERAPY
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 06/22/2008
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Provider Practice Location Address
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Address Line | 218 N WASHINGTON ST
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City | ROME
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State | NY
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Zip | 13440-5725
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Country | US
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Telephone | 315-337-1537
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4224 218 N. WASHINGTON ST.
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City | ROME
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State | NY
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Zip | 13442-4224
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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 | DIRECTOR
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Name | TIMOTHY QUINN
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Credential | LCSW-R
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Telephone | 315-337-1537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PO59006-1
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License Number State |
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