Facts
- Status
- A
- Credential
- LCSW
- Type
- Individual
- Enumeration date
- 2011-08-22
- Last updated
- 2015-05-01
Specialties
Licenses
- License NY
- 081812-1
Location
- Practice location
- 1073 MAIN ST, SUITE: 214
- City
- FISHKILL NY
- Postal code
- 125243513
- Phone
- 845-235-5102
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.