TED BORKSTROM

RONKONKOMA, NY
NPI1679868590
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2011-06-20
Last Update Date2011-06-20
Business Address
-- TED BORKSTROM CASAC
44 5TH ST
RONKONKOMA, NY 11779-5346
Phone number: 631-413-0597
Mailing Address
-- TED BORKSTROM CASAC
44 5TH ST
RONKONKOMA, NY 11779-5346
Phone number: 631-413-0597
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