MR. Gary L Short, LCSW-R

NPI #1164674677 in Bath, New York

Provider Information

NPI Number
1164674677
Entity Type
Individual
Name
MR. Gary L Short, LCSW-R
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Credential
LCSW-R
Enumeration Date
Oct 15, 2008
Last Updated
Oct 15, 2008

Practice Location

Address
7634 CAMPBELL CREEK RD
Address 2
FAMILY LIFE MINISTRIES
City
Bath
ZIP Code
14810-7612
Phone
(607) 776-4151

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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