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1851143473
RAEGAN DISTASIO
SYRACUSE, NY
NPI
1851143473
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2024-04-05
Last Update Date
2024-04-05
Business Address
RAEGAN DISTASIO
1045 JAMES ST STE 100
SYRACUSE, NY 13203-2758
Phone number: 315-472-4471
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Mailing Address
RAEGAN DISTASIO
501 THAYER RD
FAIRPORT, NY 14450-9514
Phone number: 585-472-1568
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