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1790111359
JESSICA THOMASSEN
CORAM, NY
NPI
1790111359
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: 091748-01)
Additional Taxonomies
104100000X Social Worker
Enumeration Date
2013-09-16
Last Update Date
2021-10-19
Business Address
JESSICA THOMASSEN
3600 ROUTE 112
CORAM, NY 11727-4116
Phone number: 631-338-8171
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Mailing Address
JESSICA THOMASSEN
3600 NY-112
CORAM, NY 11727
Phone number: 631-920-8630
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