Individual
ANNCHARLOTTE TAVOLACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
5225 RTE 347 STE 44, PORT JEFFERSON STATION, NY 11776-2060
(631) 403-3318
Mailing address
280 HAWKINS RD, SELDEN, NY 11784-2035
(631) 681-0310
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
001864
NY
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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