Individual
AMY ANTONIAZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
1709 MICHAEL WILLIAM RD, MERRICK, NY 11566-2523
(516) 378-3115
Mailing address
1709 MICHAEL WILLIAM RD, MERRICK, NY 11566-2523
(516) 378-3115
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
R040238
NY
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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