Individual
CHARISSE CIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1399 FRANKLIN AVE, GARDEN CITY, NY 11530-7400
(917) 563-3350
Mailing address
501 TENNYSON AVE, NORTH BALDWIN, NY 11510-2256
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
095454
NY
Other
Enumeration date
06/12/2017
Last updated
05/03/2024
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