Individual
BRIANNE O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
208 ROANOKE AVE, RIVERHEAD, NY 11901-2706
(631) 255-3657
Mailing address
42 LAFAYETTE AVE, MASTIC, NY 11950-2814
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
008466
NY
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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