THERESA ROSE DOMENICHELLO

PORT JEFF STA, NY
NPI1427646074
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: NY  106018)
Enumeration Date2021-01-08
Last Update Date2024-10-21
Business Address
THERESA ROSE DOMENICHELLO LCSW
646 MAIN ST STE 206
PORT JEFF STA, NY 11777-2230
Phone number: 631-213-9377
Mailing Address
THERESA ROSE DOMENICHELLO LCSW
41 SUNLIGHT WALK
HOLBROOK, NY 11741-4972
Phone number: 631-213-9377
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