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1710083084
MARY LORRAINE PETERSEN
CORAM, NY
NPI
1710083084
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY R023294)
Enumeration Date
2006-09-15
Last Update Date
2007-07-08
Business Address
-- MARY LORRAINE PETERSEN LCSW
705 HILLTOP CT
CORAM, NY 11727
Phone number: 631-696-4355
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Mailing Address
-- MARY LORRAINE PETERSEN LCSW
705 HILLTOP CT
CORAM, NY 11727
Phone number: 631-988-9812
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