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1437203320
MARISA BOULUKOS
MASSAPEQUA, NY
NPI
1437203320
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R042317-1)
Enumeration Date
2007-01-22
Last Update Date
2007-07-08
Business Address
Mrs. MARISA BOULUKOS lcswr
75 GRAND AVE
MASSAPEQUA, NY 11758-4905
Phone number: 516-799-3202
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Mailing Address
Mrs. MARISA BOULUKOS lcswr
57 CRESCENT COVE CT
SEAFORD, NY 11783-3649
Phone number: 561-781-9540
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