Individual
BETHANY ROSE MERLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1 ELAINE PL, ISLANDIA, NY 11749-1566
(631) 630-3915
Mailing address
1 ELAINE PL, ISLANDIA, NY 11749-1566
(631) 630-3915
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
081724
NY
Other
Enumeration date
08/02/2011
Last updated
01/26/2015
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