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Organization
DIANE GAVARES LICENSED CLINICAL SOCIAL WORKER P.C.
Active
Organization
DIANE GAVARES LICENSED CLINICAL SOCIAL WORKER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE GAVARES (LICENSED CLINICAL SOCIAL WORKER)
(631) 849-2341
Entity
Organization
Contact information
Practice address
3 MIDDLE CROSS, SHOREHAM, NY 11786-1441
(631) 849-2341
Mailing address
3 MIDDLE CROSS, SHOREHAM, NY 11786-1441
(631) 849-2341
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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