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General NPI Number Information
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NPI Number | 1811381668
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Entity Type | Organization
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Legal Business Name | MA THERAPY
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 303 SENECA RD STE C
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City | HORNELL
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State | NY
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Zip | 14843-1000
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Country | US
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Telephone | 646-662-4049
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55
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City | ALMOND
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State | NY
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Zip | 14804-0055
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Country | US
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Telephone | 646-662-4049
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMIRA R MARTIN-SALTSMAN
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Credential | LCSW-R
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Telephone | 646-662-4049
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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 | R076139
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License Number State | NY
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