Individual
MS. CONSTANCE M VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC
Contact information
Practice address
57 RENNIE ST, MALONE, NY 12953-1138
(518) 483-1460
Mailing address
275 COUNTY ROUTE 23, MALONE, NY 12953-4406
(518) 483-2312
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002267-1
NY
Other
Enumeration date
04/04/2007
Last updated
02/10/2009
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