Most Relevant Information
Provider Data
| NPI Number: | 1003691999 |
| Provider Name: | ANDREW MABON CARROLL MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | P124005 |
Most Important Dates
| Enumeration Date: | 08/29/2023 |
| Last Updated: | 08/29/2023 |
Provider Practice Location
713 HARRISON ST
SYRACUSE
NY
132102305
Practice Location Phone/Fax
| Phone: | 3154643145 |
| Fax: |
Provider Mailing Location
919 E GENESEE ST
SYRACUSE
NY
132101739
Provider Mailing Phone/Fax
| Phone: | 6106807259 |
| Fax: |