Most Relevant Information
Provider Data
| NPI Number: | 1003270349 |
| Provider Name: | TODD GEROME MIX LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 088157-1 |
Most Important Dates
| Enumeration Date: | 04/13/2016 |
| Last Updated: | 04/13/2016 |
Provider Practice Location
490 E RIDGE RD
ROCHESTER
NY
146211229
Practice Location Phone/Fax
| Phone: | 5859222570 |
| Fax: |
Provider Mailing Location
490 E RIDGE RD
ROCHESTER
NY
146211229
Provider Mailing Phone/Fax
| Phone: | 5859222570 |
| Fax: |