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1053474098
ALLEN JOHN AGNEW
ITHACA, NY
NPI
1053474098
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY casac 13121)
Enumeration Date
2006-12-19
Last Update Date
2007-07-08
Business Address
Mr. ALLEN JOHN AGNEW casac nys 13121
201 E GREEN ST SUITE 500
ITHACA, NY 14850-5635
Phone number: 607-274-6288
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Mailing Address
Mr. ALLEN JOHN AGNEW casac nys 13121
512 HIGHLAND RD
ITHACA, NY 14850-2218
Phone number: 607-257-4245
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