Individual
JASMIN DENGELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1444 5TH AVE, BAY SHORE, NY 11706-4147
(631) 647-3100
Mailing address
10 MENASHA LN, EAST ISLIP, NY 11730-2419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
079879
NY
1041S0200X
School Social Worker
079879
NY
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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