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1902110059
KRISTIN ERICSON
PORT JEFFERSON, NY
NPI
1902110059
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041S0200X Social Worker, School
(Licence: NY R047177-1)
Enumeration Date
2010-07-31
Last Update Date
2010-09-10
Business Address
Mrs. KRISTIN ERICSON LCSW
118 SPRING ST
PORT JEFFERSON, NY 11777-1817
Phone number: 631-476-0564
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Mailing Address
Mrs. KRISTIN ERICSON LCSW
95 GREENPORT AVE
MEDFORD, NY 11763-3728
Phone number: 631-654-1967
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