Individual
MRS. GRACE ANN REYNOLDS VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
28 WOOD RD, CENTEREACH, NY 11720-1620
(631) 471-6400
Mailing address
28 WOOD RD, CENTEREACH, NY 11720-1620
(631) 471-6400
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
R080813-1
NY
Other
Enumeration date
11/02/2011
Last updated
09/30/2014
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