Provider Information for 1194099689
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Ms. JUDITH MARIE LATHROP MS, LMFT
Sex: Female
NPI: 1194099689
Last Updated: 2012-02-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1194099689 | ||||||||
| Enumeration Date | 2012-02-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2510 STATE HIGHWAY 80 SHERBURNE, NY 13460-4606 United States Phone: 607-674-5196 | Fax:607-674-5196 | ||||||||
| Primary Practice Address | 7266 BUCKLEY RD BRIGHT PATH COUNSELING CENTER NORTH SYRACUSE, NY 13212-2649 United States Phone: 315-458-0919 | Fax: | ||||||||
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