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1497787188
ALLYSA J WACHHOLDER
PORT JEFFERSON STATION, NY
NPI
1497787188
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 074310)
Enumeration Date
2006-07-06
Last Update Date
2007-07-08
Business Address
-- ALLYSA J WACHHOLDER LCSW
36 CLYMER ST
PORT JEFFERSON STATION, NY 11776-3913
Phone number: 631-828-6024
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Mailing Address
-- ALLYSA J WACHHOLDER LCSW
36 CLYMER ST
PORT JEFFERSON STATION, NY 11776-3913
Phone number: 631-828-6024
Copy
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