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Organization
SUSAN BOUTON CSW PC
Active
Organization
SUSAN BOUTON CSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BOUTON CSW (PRESIDENT)
(516) 759-9340
Entity
Organization
Contact information
Practice address
25 WIMBLEDON DR, ROSLYN, NY 11576-3084
(516) 759-9340
Mailing address
25 WIMBLEDON DR, ROSLYN, NY 11576-3084
(516) 759-9340
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R033006-1
NY
Other
Enumeration date
09/18/2012
Last updated
06/04/2013
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