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Organization
TOWN OF ISLIP
Active
Organization
TOWN OF ISLIP
Active
Other names
Acceso
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES BOCKLET (DIRECTOR)
(631) 224-5330
Entity
Organization
Contact information
Practice address
452 SUFFOLK AVE, BRENTWOOD, NY 11717
(631) 436-6065
(631) 436-6068
Mailing address
452 SUFFOLK AVE, BRENTWOOD, NY 11717
(631) 436-6065
(631) 436-6068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
080611082
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
091111083
NY
Other
Enumeration date
09/29/2006
Last updated
09/23/2008
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