Provider Demographics
NPI:1609421288
Name:LAW, TORI MARIE (OP THERAPIST)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:MARIE
Last Name:LAW
Suffix:
Gender:F
Credentials:OP THERAPIST
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:MARIE
Other - Last Name:HASTINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:7652 DOUBLETREE CIR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1241
Mailing Address - Country:US
Mailing Address - Phone:607-221-5136
Mailing Address - Fax:
Practice Address - Street 1:321 W ONONDAGA ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3207
Practice Address - Country:US
Practice Address - Phone:315-478-0610
Practice Address - Fax:315-295-2031
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420800Medicaid