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1306062203
MARK DIBERNARDO
LATHAM, NY
NPI
1306062203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-18
Last Update Date
2007-07-08
Business Address
-- MARK DIBERNARDO
636 NEW LOUDON RD
LATHAM, NY 12110-4002
Phone number: 518-783-5381
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Mailing Address
-- MARK DIBERNARDO
636 NEW LOUDON RD
LATHAM, NY 12110-4002
Phone number: 518-783-5381
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