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1235193962
BRUCE TEALL
PENFIELD, NY
NPI
1235193962
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R054197-1)
Enumeration Date
2006-04-12
Last Update Date
2007-07-08
Business Address
Mr. BRUCE TEALL LCSW
401 PENFIELD DR. BLDG #3
PENFIELD, NY 14526
Phone number: 585-314-4618
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Mailing Address
Mr. BRUCE TEALL LCSW
11 SENECA AVE
GENESEO, NY 14454-9508
Phone number: 585-314-4618
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