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1306281738
ALPHONSO TRESVONT CHAMPAGNE
MOUNT VERNON, NY
NPI
1306281738
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 22129)
Enumeration Date
2013-04-29
Last Update Date
2013-04-29
Business Address
-- ALPHONSO TRESVONT CHAMPAGNE CASAC-T
54 S 3RD AVE
MOUNT VERNON, NY 10550-3303
Phone number: 914-664-4042
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Mailing Address
-- ALPHONSO TRESVONT CHAMPAGNE CASAC-T
54 S 3RD AVE
MOUNT VERNON, NY 10550-3303
Phone number: 914-380-4942
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