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Individual
MISS ROXANA MARISOL SERVELLON
Active
Individual
MISS ROXANA MARISOL SERVELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CASAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2-22379
NY
1041C0700X
Clinical Social Worker
Primary
084222
NY
Other
Enumeration date
10/30/2014
Last updated
06/23/2017
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