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Individual
MARIE MISTRETTA
Active
Individual
MARIE MISTRETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R016968
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062688
VALUE OPTIONS
NY
01
—
7404230
GHI NY
NY
01
—
NX4412
BC BS EMPIRE NY
NY
01
—
P3637040
OXFORD
NY
Enumeration date
03/27/2007
Last updated
07/08/2007
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