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Individual
MS. JOANN PARK
Active
Individual
MS. JOANN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
073998
NY
1041C0700X
Clinical Social Worker
Primary
073998-1
NY
Other
Enumeration date
06/04/2009
Last updated
10/25/2018
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