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1023163110
DOROTHY ELLEN LYSTAD
LONG BEACH, NY
NPI
1023163110
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Former Name
DOROTHY ELLEN SEGAL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R029041)
Enumeration Date
2007-01-25
Last Update Date
2007-07-08
Business Address
Ms. DOROTHY ELLEN LYSTAD
260 EDWARDS BLVD
LONG BEACH, NY 11561
Phone number: 516-432-7905
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Mailing Address
Ms. DOROTHY ELLEN LYSTAD
260 EDWARDS BLVD
LONG BEACH, NY 11561
Phone number: 516-432-7905
Copy
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