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1740540129
CARLICE CECIL RUTTAN
WATERTOWN, NY
NPI
1740540129
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 079048-1)
Enumeration Date
2012-05-21
Last Update Date
2012-05-21
Business Address
Mr. CARLICE CECIL RUTTAN LCSW
165 COLEMAN AVE
WATERTOWN, NY 13601-2217
Phone number: 315-782-2061
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Mailing Address
Mr. CARLICE CECIL RUTTAN LCSW
165 COLEMAN AVE
WATERTOWN, NY 13601-2217
Phone number: 315-782-2061
Copy
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