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1922872498
JOHNNY FANG
ITHACA, NY
NPI
1922872498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 121286)
Enumeration Date
2023-11-14
Last Update Date
2023-11-14
Business Address
JOHNNY FANG MSW, LMSW
201 E GREEN ST FL 4
ITHACA, NY 14850-5635
Phone number: 607-274-6338
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Mailing Address
JOHNNY FANG MSW, LMSW
408 W CLINTON ST APT 1
ITHACA, NY 14850-5265
Phone number: 857-654-0744
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