JEFFREY WITHERSPOON

MASSAPEQUA, NY
NPI1053706739
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  6560)
Enumeration Date2015-03-31
Last Update Date2015-03-31
Business Address
-- JEFFREY WITHERSPOON CASAC
98 DIVISION AVE
MASSAPEQUA, NY 11758-7101
Phone number: 516-398-7298
Mailing Address
-- JEFFREY WITHERSPOON CASAC
98 DIVISION AVE
MASSAPEQUA, NY 11758-7101
Phone number: 516-398-7298
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