Individual
ANIA BIANCA WASOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MELVILLE PARK RD, MELVILLE, NY 11747-3175
(631) 204-3434
Mailing address
18 S 34TH PL, WYANDANCH, NY 11798-3600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
02/05/2020
Last updated
02/05/2020
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