Individual
MS. MARJORIE THADAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
2367-69 SECOND AVENUE, NEW YORK, NY 10035
(212) 876-2300
Mailing address
2367-69 SECOND AVENUE, NEW YORK, NY 10035
(212) 876-2300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7256
NY
Other
Enumeration date
09/23/2008
Last updated
09/23/2008
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