Provider Demographics
NPI:1124695101
Name:PREMO, FRANCESCA MARIE
Entity type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:MARIE
Last Name:PREMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-2544
Mailing Address - Country:US
Mailing Address - Phone:315-992-2486
Mailing Address - Fax:
Practice Address - Street 1:1 FRANKLIN SQ STE 301
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-3439
Practice Address - Country:US
Practice Address - Phone:315-665-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health