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Individual
JESSICA A VASSALLO
Active
Individual
JESSICA A VASSALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
076502
NY
Other
Enumeration date
11/15/2011
Last updated
10/10/2023
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