Provider First Line Business Practice Location Address:
5862 US HIGHWAY 11 THE TALLMAN HOUSE
Provider Second Line Business Practice Location Address:
PSYCHOLOGICAL ASSOCIATES
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-262-5355
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2006