Individual
JAIME MARIE D'AVANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
37 JOHN ST, AMITYVILLE, NY 11701-2930
(631) 424-2900
(631) 598-5716
Mailing address
37 JOHN ST, AMITYVILLE, NY 11701-2930
(631) 424-2900
(631) 598-5716
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000721
NY
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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