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General NPI Number Information
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NPI Number | 1508524331
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Entity Type | Individual
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Provider Name | MARY KATHRYN GIGLIOTTI-TUPAJ ATR-BC,LCAT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 8257 SENECA TPKE
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City | CLINTON
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State | NY
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Zip | 13323-1119
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Country | US
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Telephone | 315-796-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 8257 SENECA TPKE
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City | CLINTON
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State | NY
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Zip | 13323-1119
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Country | US
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Telephone | 315-796-1065
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 001878-02
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License Number State | NY
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