DIANCO LAVENSKI HOLDER

KEW GARDENS, NY
NPI1962964510
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  33557)
Enumeration Date2019-04-03
Last Update Date2021-08-31
Business Address
DIANCO LAVENSKI HOLDER CASAC
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415-3607
Phone number: 718-520-1513
Mailing Address
DIANCO LAVENSKI HOLDER CASAC
100 ACACIA AVE
HEMPSTEAD, NY 11550-7021
Phone number:
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